Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $156.02 / $195.55 / $316.08	Facility	26	$156.02	$195.55	$316.08
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $151.72 / $300.00 / $2,158.79	Facility	26	$151.72	$300.00	$2,158.79
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $141.32 / $254.84 / $3,296.63	Facility	26	$141.32	$254.84	$3,296.63
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $176.40 / $213.67 / $231.20	Facility	26	$176.40	$213.67	$231.20
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $151.72 / $151.72 / $154.02	Facility	26	$151.72	$151.72	$154.02
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $2,158.79 / $2,158.79 / $3,064.39	Facility	26	$2,158.79	$2,158.79	$3,064.39