Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $94.22 / $94.22 / $396.60	Facility		$94.22	$94.22	$396.60
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $75.69 / $98.73 / $216.56	Facility		$75.69	$98.73	$216.56
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $92.25 / $137.35 / $144.05	Facility		$92.25	$137.35	$144.05
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $94.22 / $94.22 / $94.22	Facility		$94.22	$94.22	$94.22
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