Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.50 / $344.00 / $434.80	Facility		$50.50	$344.00	$434.80
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $108.07 / $410.80 / $700.00	Professional	AA	$108.07	$410.80	$700.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $100.55 / $100.55 / $100.55	Professional	AA	$100.55	$100.55	$100.55
Asuris Northwest Health Facility/Professional Professional Modifier QX Low / Median / High Price $133.75 / $152.50 / $216.35	Professional	QX	$133.75	$152.50	$216.35
Asuris Northwest Health Facility/Professional Professional Modifier QY Low / Median / High Price $133.75 / $152.50 / $216.35	Professional	QY	$133.75	$152.50	$216.35
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $212.50 / $260.00 / $345.00	Facility		$212.50	$260.00	$345.00
Regence BlueShield Facility/Professional Professional Modifier QX Low / Median / High Price $133.75 / $161.25 / $210.50	Professional	QX	$133.75	$161.25	$210.50
Regence BlueShield Facility/Professional Professional Modifier QY Low / Median / High Price $133.75 / $161.25 / $210.50	Professional	QY	$133.75	$161.25	$210.50