Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.52 / $161.02 / $389.03	Facility	26	$128.52	$161.02	$389.03
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $93.69 / $742.00 / $964.10	Facility	26	$93.69	$742.00	$964.10
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $133.91 / $284.58 / $371.27	Facility	26	$133.91	$284.58	$371.27
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $112.75 / $164.02 / $275.37	Facility	26	$112.75	$164.02	$275.37
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $93.69 / $93.69 / $120.95	Facility	26	$93.69	$93.69	$120.95