Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $205.02 / $276.83 / $433.09	Facility	26	$205.02	$276.83	$433.09
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $217.53 / $717.54 / $717.54	Facility	26	$217.53	$717.54	$717.54
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $136.19 / $225.67 / $401.31	Facility	26	$136.19	$225.67	$401.31
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $226.38 / $309.26 / $318.92	Facility	26	$226.38	$309.26	$318.92
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $214.27 / $214.27 / $217.53	Facility	26	$214.27	$214.27	$217.53
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $1,784.45 / $1,784.45 / $3,043.22	Facility	26	$1,784.45	$1,784.45	$3,043.22