Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $202.81 / $276.60 / $431.38	Facility	26	$202.81	$276.60	$431.38
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $211.13 / $725.43 / $725.43	Facility	26	$211.13	$725.43	$725.43
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $143.93 / $237.45 / $401.31	Facility	26	$143.93	$237.45	$401.31
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $254.10 / $306.30 / $322.91	Facility	26	$254.10	$306.30	$322.91
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $210.65 / $210.65 / $211.13	Facility	26	$210.65	$210.65	$211.13