Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.44 / $67.06 / $265.66	Facility		$28.44	$67.06	$265.66
Aetna Facility/Professional Facility Modifier CO Low / Median / High Price $60.24 / $137.58 / $137.58	Facility	CO	$60.24	$137.58	$137.58
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $44.72 / $91.72 / $405.09	Facility	CQ	$44.72	$91.72	$405.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.48 / $28.45 / $222.00	Professional		$12.48	$28.45	$222.00
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $40.96 / $52.79 / $125.40	Professional	CQ	$40.96	$52.79	$125.40
Ambetter Facility/Professional Professional Modifier CQ Low / Median / High Price $40.54 / $40.54 / $55.23	Professional	CQ	$40.54	$40.54	$55.23
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $39.40 / $78.20 / $134.74	Facility		$39.40	$78.20	$134.74
Asuris Northwest Health Facility/Professional Facility Modifier CO Low / Median / High Price $42.50 / $56.39 / $114.53	Facility	CO	$42.50	$56.39	$114.53
Asuris Northwest Health Facility/Professional Facility Modifier CQ Low / Median / High Price $42.50 / $56.39 / $114.53	Facility	CQ	$42.50	$56.39	$114.53
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $28.94 / $51.44 / $246.08	Professional		$28.94	$51.44	$246.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $90.00 / $108.00 / $118.00	Facility		$90.00	$108.00	$118.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.25 / $57.86 / $104.88	Professional		$27.25	$57.86	$104.88
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $28.89 / $40.36 / $76.31	Facility		$28.89	$40.36	$76.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $26.97 / $40.04 / $72.28	Professional		$26.97	$40.04	$72.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $15.64 / $18.87 / $23.16	Professional		$15.64	$18.87	$23.16
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $42.63 / $58.29 / $61.64	Facility		$42.63	$58.29	$61.64
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $39.40 / $52.92 / $78.20	Facility		$39.40	$52.92	$78.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.61 / $55.25 / $73.86	Professional		$40.61	$55.25	$73.86
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $37.28 / $43.94 / $79.36	Facility		$37.28	$43.94	$79.36
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $28.54 / $30.36 / $46.03	Professional		$28.54	$30.36	$46.03
United Facility/Professional Professional Modifier Low / Median / High Price $24.47 / $31.40 / $77.09	Professional		$24.47	$31.40	$77.09
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $29.38 / $32.43 / $32.43	Professional		$29.38	$32.43	$32.43