Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $90.00 / $123.10 / $219.30	Facility		$90.00	$123.10	$219.30
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $117.52 / $117.52 / $117.52	Facility		$117.52	$117.52	$117.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $117.52 / $117.52 / $117.52	Professional		$117.52	$117.52	$117.52
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $75.58 / $101.17 / $109.48	Facility		$75.58	$101.17	$109.48