Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.11 / $67.58 / $105.36	Facility	26	$50.11	$67.58	$105.36
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $52.10 / $171.05 / $171.05	Facility	26	$52.10	$171.05	$171.05
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $32.40 / $55.43 / $98.11	Facility	26	$32.40	$55.43	$98.11
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $54.88 / $74.65 / $76.38	Facility	26	$54.88	$74.65	$76.38
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $51.64 / $51.64 / $52.10	Facility	26	$51.64	$51.64	$52.10
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $946.29 / $946.29 / $1,497.68	Facility	26	$946.29	$946.29	$1,497.68