Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $101.10 / $136.63 / $216.74	Facility	26	$101.10	$136.63	$216.74
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $105.57 / $346.65 / $346.65	Facility	26	$105.57	$346.65	$346.65
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $65.88 / $112.83 / $198.08	Facility	26	$65.88	$112.83	$198.08
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $112.70 / $151.54 / $154.77	Facility	26	$112.70	$151.54	$154.77
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $105.10 / $105.10 / $105.57	Facility	26	$105.10	$105.10	$105.57
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $946.29 / $946.29 / $3,043.22	Facility	26	$946.29	$946.29	$3,043.22