Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,768.51 / $5,272.80	Facility		$55.00	$1,768.51	$5,272.80
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,869.84 / $3,329.86 / $11,316.75	Professional		$1,869.84	$3,329.86	$11,316.75
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,554.31 / $2,800.67 / $3,401.37	Facility		$1,554.31	$2,800.67	$3,401.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,639.45 / $2,800.67 / $3,401.37	Professional		$1,639.45	$2,800.67	$3,401.37
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,885.67 / $2,588.88 / $2,663.25	Facility		$1,885.67	$2,588.88	$2,663.25
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,768.51 / $1,768.51 / $1,816.58	Facility		$1,768.51	$1,768.51	$1,816.58
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,886.67 / $3,030.14 / $3,725.77	Professional		$1,886.67	$3,030.14	$3,725.77