Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $2,090.67 / $4,919.43	Facility		$55.00	$2,090.67	$4,919.43
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $155.13 / $491.94 / $491.94	Facility	AS	$155.13	$491.94	$491.94
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,128.40 / $2,349.73 / $3,002.96	Facility		$1,128.40	$2,349.73	$3,002.96
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,699.81 / $2,323.56 / $2,401.94	Facility		$1,699.81	$2,323.56	$2,401.94
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,609.51 / $1,638.35 / $3,875.03	Facility		$1,609.51	$1,638.35	$3,875.03