Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $411.62 / $523.74 / $853.22	Facility	26	$411.62	$523.74	$853.22
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $411.32 / $2,803.28 / $5,624.10	Facility	26	$411.32	$2,803.28	$5,624.10
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $382.38 / $689.53 / $10,775.99	Facility	26	$382.38	$689.53	$10,775.99
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $484.12 / $579.87 / $619.45	Facility	26	$484.12	$579.87	$619.45
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $411.32 / $411.32 / $414.50	Facility	26	$411.32	$411.32	$414.50
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