Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.50 / $550.40 / $695.68	Facility		$50.50	$550.40	$695.68
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $805.80 / $1,136.33 / $1,820.00	Professional	AA	$805.80	$1,136.33	$1,820.00
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $84.00 / $84.00 / $1,230.23	Professional	QX	$84.00	$84.00	$1,230.23
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $267.95 / $759.15 / $991.98	Professional	AA	$267.95	$759.15	$991.98
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $225.33 / $478.40 / $565.07	Professional	QK	$225.33	$478.40	$565.07
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $189.55 / $225.33 / $225.33	Professional	QX	$189.55	$225.33	$225.33
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $193.90 / $243.60 / $720.00	Professional	QZ	$193.90	$243.60	$720.00
Asuris Northwest Health Facility/Professional Professional Modifier QK Low / Median / High Price $214.00 / $244.00 / $346.16	Professional	QK	$214.00	$244.00	$346.16
Asuris Northwest Health Facility/Professional Professional Modifier QX Low / Median / High Price $214.00 / $253.00 / $364.52	Professional	QX	$214.00	$253.00	$364.52
Cigna Facility/Professional Professional Modifier QK Low / Median / High Price $240.00 / $240.00 / $240.00	Professional	QK	$240.00	$240.00	$240.00
Cigna Facility/Professional Professional Modifier QX Low / Median / High Price $240.00 / $240.00 / $240.00	Professional	QX	$240.00	$240.00	$240.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $340.00 / $416.00 / $552.00	Facility		$340.00	$416.00	$552.00
Regence BlueShield Facility/Professional Professional Modifier QK Low / Median / High Price $214.00 / $258.00 / $336.80	Professional	QK	$214.00	$258.00	$336.80
Regence BlueShield Facility/Professional Professional Modifier QX Low / Median / High Price $214.00 / $258.00 / $336.80	Professional	QX	$214.00	$258.00	$336.80