Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $158.96 / $200.58 / $323.68	Facility	26	$158.96	$200.58	$323.68
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $154.47 / $324.00 / $11,792.25	Facility	26	$154.47	$324.00	$11,792.25
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $145.56 / $258.23 / $19,039.34	Facility	26	$145.56	$258.23	$19,039.34
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $176.89 / $216.09 / $234.60	Facility	26	$176.89	$216.09	$234.60
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $154.47 / $154.47 / $156.29	Facility	26	$154.47	$154.47	$156.29
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $11,792.25 / $11,792.25 / $17,910.32	Facility	26	$11,792.25	$11,792.25	$17,910.32