Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $415.33 / $624.28 / $852.49	Facility	26	$415.33	$624.28	$852.49
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $412.23 / $2,772.64 / $2,772.64	Facility	26	$412.23	$2,772.64	$2,772.64
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $289.85 / $397.37 / $744.75	Facility	26	$289.85	$397.37	$744.75
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $490.98 / $572.44 / $618.79	Facility	26	$490.98	$572.44	$618.79
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $409.93 / $412.23 / $412.23	Facility	26	$409.93	$412.23	$412.23