Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $99.90 / $127.65 / $208.75	Facility	26	$99.90	$127.65	$208.75
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.08 / $154.61 / $412.00	Facility	26	$100.08	$154.61	$412.00
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $71.92 / $160.22 / $193.23	Facility	26	$71.92	$160.22	$193.23
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $110.74 / $141.13 / $149.41	Facility	26	$110.74	$141.13	$149.41
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $100.08 / $100.08 / $100.11	Facility	26	$100.08	$100.08	$100.11