Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $588.03 / $736.67 / $936.82	Facility	26	$588.03	$736.67	$936.82
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $563.48 / $3,906.24 / $5,745.35	Facility	26	$563.48	$3,906.24	$5,745.35
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $536.86 / $936.10 / $1,151.15	Facility	26	$536.86	$936.10	$1,151.15
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $573.80 / $813.37 / $826.11	Facility	26	$573.80	$813.37	$826.11
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $563.48 / $563.48 / $563.48	Facility	26	$563.48	$563.48	$563.48
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $5,745.35 / $5,745.35 / $9,980.91	Facility	26	$5,745.35	$5,745.35	$9,980.91