Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $140.16 / $156.16 / $320.76	Facility	26	$140.16	$156.16	$320.76
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $109.22 / $1,725.00 / $3,303.00	Facility	26	$109.22	$1,725.00	$3,303.00
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $110.67 / $237.61 / $283.97	Facility	26	$110.67	$237.61	$283.97
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $131.11 / $165.62 / $232.56	Facility	26	$131.11	$165.62	$232.56
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $109.22 / $109.22 / $125.48	Facility	26	$109.22	$109.22	$125.48