Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $171.99 / $275.63 / $355.04	Facility	26	$171.99	$275.63	$355.04
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $896.96 / $1,169.20 / $1,169.20	Facility	26	$896.96	$1,169.20	$1,169.20
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $132.66 / $266.54 / $433.56	Facility	26	$132.66	$266.54	$433.56
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $202.30 / $243.79 / $259.83	Facility	26	$202.30	$243.79	$259.83
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $936.81 / $936.81 / $1,640.24	Facility	26	$936.81	$936.81	$1,640.24