Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.30 / $64.45 / $106.50	Facility	26	$51.30	$64.45	$106.50
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $47.99 / $103.83 / $2,158.79	Facility	26	$47.99	$103.83	$2,158.79
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $46.68 / $84.18 / $3,296.63	Facility	26	$46.68	$84.18	$3,296.63
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $57.75 / $70.03 / $97.60	Facility	26	$57.75	$70.03	$97.60
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $47.99 / $47.99 / $49.38	Facility	26	$47.99	$47.99	$49.38
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