Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $229.31 / $289.29 / $469.83	Facility	26	$229.31	$289.29	$469.83
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $225.30 / $1,725.00 / $2,310.00	Facility	26	$225.30	$1,725.00	$2,310.00
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $162.44 / $359.60 / $436.72	Facility	26	$162.44	$359.60	$436.72
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $271.14 / $316.79 / $341.36	Facility	26	$271.14	$316.79	$341.36
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $225.30 / $225.30 / $227.41	Facility	26	$225.30	$225.30	$227.41