Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $156.88 / $278.13 / $570.52	Facility		$156.88	$278.13	$570.52
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $128.37 / $641.84 / $1,069.73	Professional		$128.37	$641.84	$1,069.73
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $128.37 / $142.63 / $242.47	Facility		$128.37	$142.63	$242.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $128.37 / $142.63 / $356.58	Professional		$128.37	$142.63	$356.58
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 $142.63 / $249.60 / $442.15	Facility		$142.63	$249.60	$442.15
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.37 / $178.29 / $215.37	Professional		$128.37	$178.29	$215.37