Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $141.46 / $182.11 / $925.25	Facility		$141.46	$182.11	$925.25
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $151.81 / $204.29 / $419.06	Facility		$151.81	$204.29	$419.06
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $161.99 / $268.55 / $277.69	Facility		$161.99	$268.55	$277.69
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $182.11 / $182.11 / $182.11	Facility		$182.11	$182.11	$182.11
United Facility/Professional Facility Modifier Low / Median / High Price $1,220.00 / $1,387.00 / $2,136.00	Facility		$1,220.00	$1,387.00	$2,136.00