Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $836.88 / $1,055.88 / $1,714.16	Facility	26	$836.88	$1,055.88	$1,714.16
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $821.23 / $5,558.40 / $11,792.25	Facility	26	$821.23	$5,558.40	$11,792.25
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $767.73 / $1,384.42 / $19,039.34	Facility	26	$767.73	$1,384.42	$19,039.34
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $974.12 / $1,151.45 / $1,246.20	Facility	26	$974.12	$1,151.45	$1,246.20
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $821.23 / $821.23 / $829.44	Facility	26	$821.23	$821.23	$829.44
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