Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $418.46 / $534.16 / $867.25	Facility	26	$418.46	$534.16	$867.25
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $417.67 / $2,843.92 / $5,624.10	Facility	26	$417.67	$2,843.92	$5,624.10
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $389.17 / $701.78 / $10,775.99	Facility	26	$389.17	$701.78	$10,775.99
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $491.96 / $588.30 / $626.96	Facility	26	$491.96	$588.30	$626.96
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $417.67 / $417.67 / $420.44	Facility	26	$417.67	$417.67	$420.44
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $5,624.10 / $5,624.10 / $9,482.39	Facility	26	$5,624.10	$5,624.10	$9,482.39