Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $522.16 / $658.66 / $1,065.54	Facility	26	$522.16	$658.66	$1,065.54
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $511.84 / $2,165.69 / $11,792.25	Facility	26	$511.84	$2,165.69	$11,792.25
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $477.87 / $861.72 / $19,039.34	Facility	26	$477.87	$861.72	$19,039.34
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $613.34 / $715.55 / $783.90	Facility	26	$613.34	$715.55	$783.90
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $511.84 / $511.84 / $515.97	Facility	26	$511.84	$511.84	$515.97
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