Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.50 / $412.80 / $521.76	Facility		$50.50	$412.80	$521.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.81 / $45.10 / $477.96	Professional		$33.81	$45.10	$477.96
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $543.15 / $1,260.00 / $1,260.00	Professional	AA	$543.15	$1,260.00	$1,260.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $292.56 / $435.84 / $2,880.00	Professional		$292.56	$435.84	$2,880.00
Asuris Northwest Health Facility/Professional Professional Modifier QX Low / Median / High Price $160.50 / $183.00 / $259.62	Professional	QX	$160.50	$183.00	$259.62
Asuris Northwest Health Facility/Professional Professional Modifier QY Low / Median / High Price $160.50 / $183.00 / $259.62	Professional	QY	$160.50	$183.00	$259.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $265.00 / $345.00 / $474.50	Professional		$265.00	$345.00	$474.50
Cigna Facility/Professional Professional Modifier QX Low / Median / High Price $180.00 / $180.00 / $180.00	Professional	QX	$180.00	$180.00	$180.00
Cigna Facility/Professional Professional Modifier QY Low / Median / High Price $180.00 / $180.00 / $180.00	Professional	QY	$180.00	$180.00	$180.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.30 / $80.00 / $185.50	Professional		$58.30	$80.00	$185.50
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $255.00 / $312.00 / $414.00	Facility		$255.00	$312.00	$414.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $292.00 / $364.00 / $454.30	Professional		$292.00	$364.00	$454.30
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $321.00 / $387.00 / $505.20	Professional		$321.00	$387.00	$505.20
Regence BlueShield Facility/Professional Professional Modifier QX Low / Median / High Price $160.50 / $193.50 / $252.60	Professional	QX	$160.50	$193.50	$252.60
Regence BlueShield Facility/Professional Professional Modifier QY Low / Median / High Price $160.50 / $193.50 / $252.60	Professional	QY	$160.50	$193.50	$252.60
United Facility/Professional Professional Modifier Low / Median / High Price $46.74 / $62.00 / $91.17	Professional		$46.74	$62.00	$91.17
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $103.38 / $103.38 / $103.38	Professional		$103.38	$103.38	$103.38