Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.44 / $40.84 / $174.52	Facility		$28.44	$40.84	$174.52
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $32.36 / $99.74 / $348.00	Facility	CQ	$32.36	$99.74	$348.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.40 / $22.12 / $74.54	Professional		$14.40	$22.12	$74.54
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $20.99 / $21.66 / $39.21	Professional	CQ	$20.99	$21.66	$39.21
Ambetter Facility/Professional Professional Modifier CQ Low / Median / High Price $40.54 / $40.54 / $40.54	Professional	CQ	$40.54	$40.54	$40.54
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $39.40 / $58.80 / $134.74	Facility		$39.40	$58.80	$134.74
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 $28.13 / $49.38 / $246.08	Professional		$28.13	$49.38	$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 $26.93 / $56.59 / $94.86	Professional		$26.93	$56.59	$94.86
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $26.13 / $36.51 / $73.28	Facility		$26.13	$36.51	$73.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $26.13 / $37.76 / $69.20	Professional		$26.13	$37.76	$69.20
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 $37.72 / $53.60 / $58.96	Facility		$37.72	$53.60	$58.96
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 $40.57 / $55.25 / $73.86	Professional		$40.57	$55.25	$73.86
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $37.28 / $43.94 / $78.45	Facility		$37.28	$43.94	$78.45
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $28.59 / $30.36 / $50.58	Professional		$28.59	$30.36	$50.58
United Facility/Professional Professional Modifier Low / Median / High Price $24.47 / $31.04 / $77.09	Professional		$24.47	$31.04	$77.09
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $29.38 / $32.43 / $32.43	Professional		$29.38	$32.43	$32.43