Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.56 / $120.04 / $156.86	Facility	26	$75.56	$120.04	$156.86
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $110.60 / $177.00 / $256.38	Facility	26	$110.60	$177.00	$256.38
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $52.48 / $76.14 / $150.19	Facility	26	$52.48	$76.14	$150.19
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $86.73 / $107.20 / $110.16	Facility	26	$86.73	$107.20	$110.16
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $73.39 / $73.39 / $73.58	Facility	26	$73.39	$73.39	$73.58
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $524.23 / $524.23 / $1,112.20	Facility	26	$524.23	$524.23	$1,112.20