Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.15 / $122.42 / $253.55	Facility	26	$96.15	$122.42	$253.55
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $95.58 / $198.74 / $401.31	Facility	26	$95.58	$198.74	$401.31
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $89.28 / $192.62 / $238.79	Facility	26	$89.28	$192.62	$238.79
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $115.50 / $140.69 / $182.24	Facility	26	$115.50	$140.69	$182.24
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $95.58 / $95.58 / $95.97	Facility	26	$95.58	$95.58	$95.97