Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.17 / $88.33 / $282.00	Facility		$33.17	$88.33	$282.00
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $43.87 / $94.91 / $442.43	Facility	CQ	$43.87	$94.91	$442.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.98 / $31.65 / $260.00	Professional		$14.98	$31.65	$260.00
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $39.27 / $45.41 / $76.93	Professional	CQ	$39.27	$45.41	$76.93
Ambetter Facility/Professional Professional Modifier CQ Low / Median / High Price $45.12 / $45.12 / $61.46	Professional	CQ	$45.12	$45.12	$61.46
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $45.75 / $73.68 / $149.85	Facility		$45.75	$73.68	$149.85
Asuris Northwest Health Facility/Professional Facility Modifier CQ Low / Median / High Price $42.50 / $62.75 / $127.37	Facility	CQ	$42.50	$62.75	$127.37
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $32.96 / $57.33 / $282.60	Professional		$32.96	$57.33	$282.60
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 $31.02 / $60.76 / $105.64	Professional		$31.02	$60.76	$105.64
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $30.69 / $43.05 / $84.31	Facility		$30.69	$43.05	$84.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.69 / $43.70 / $81.51	Professional		$30.69	$43.70	$81.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.64 / $49.34 / $87.33	Professional		$9.64	$49.34	$87.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $46.51 / $63.92 / $67.67	Facility		$46.51	$63.92	$67.67
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $45.75 / $60.80 / $89.85	Facility		$45.75	$60.80	$89.85
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.61 / $63.41 / $84.61	Professional		$46.61	$63.41	$84.61
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $42.79 / $50.43 / $90.31	Facility		$42.79	$50.43	$90.31
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $32.76 / $34.85 / $58.05	Professional		$32.76	$34.85	$58.05
United Facility/Professional Professional Modifier Low / Median / High Price $27.22 / $36.09 / $87.18	Professional		$27.22	$36.09	$87.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $32.69 / $36.09 / $36.09	Professional		$32.69	$36.09	$36.09