Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $292.76 / $371.63 / $603.90	Facility	26	$292.76	$371.63	$603.90
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $286.54 / $1,940.48 / $2,158.79	Facility	26	$286.54	$1,940.48	$2,158.79
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $270.76 / $488.26 / $3,296.63	Facility	26	$270.76	$488.26	$3,296.63
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $344.53 / $402.08 / $452.27	Facility	26	$344.53	$402.08	$452.27
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $286.54 / $286.54 / $290.37	Facility	26	$286.54	$286.54	$290.37
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