Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $121.24 / $121.24 / $121.24	Professional		$121.24	$121.24	$121.24
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $128.37 / $677.49 / $677.49	Facility		$128.37	$677.49	$677.49
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $159.75 / $710.30 / $1,069.73	Professional		$159.75	$710.30	$1,069.73
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $128.37 / $142.63 / $718.71	Facility		$128.37	$142.63	$718.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $128.37 / $142.63 / $356.58	Professional		$128.37	$142.63	$356.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $75.00	Professional		$75.00	$75.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $142.63 / $142.63 / $142.63	Facility		$142.63	$142.63	$142.63
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $128.37 / $128.37 / $142.63	Facility		$128.37	$128.37	$142.63
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.37 / $178.29 / $215.37	Professional		$128.37	$178.29	$215.37