Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $45.00 / $45.00 / $52.39	Facility		$45.00	$45.00	$52.39
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $35.00 / $115.00 / $300.00	Facility		$35.00	$115.00	$300.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $45.00 / $45.00 / $49.77	Facility		$45.00	$45.00	$49.77