Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $125.65 / $159.93 / $260.27	Facility	26	$125.65	$159.93	$260.27
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $125.48 / $196.55 / $532.00	Facility	26	$125.48	$196.55	$532.00
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $89.28 / $198.65 / $239.87	Facility	26	$89.28	$198.65	$239.87
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $138.18 / $176.87 / $186.26	Facility	26	$138.18	$176.87	$186.26
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $125.48 / $125.48 / $126.13	Facility	26	$125.48	$125.48	$126.13