Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $237.66 / $320.39 / $496.64	Facility	26	$237.66	$320.39	$496.64
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $245.07 / $770.52 / $770.52	Facility	26	$245.07	$770.52	$770.52
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $150.90 / $251.16 / $429.15	Facility	26	$150.90	$251.16	$429.15
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $261.66 / $334.01 / $360.40	Facility	26	$261.66	$334.01	$360.40
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $230.79 / $230.79 / $245.07	Facility	26	$230.79	$230.79	$245.07