Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.07 / $63.90 / $244.40	Facility		$26.07	$63.90	$244.40
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $27.68 / $55.11 / $155.19	Facility	CQ	$27.68	$55.11	$155.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.52 / $25.79 / $171.71	Professional		$13.52	$25.79	$171.71
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $19.44 / $40.11 / $117.00	Professional	CQ	$19.44	$40.11	$117.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $36.24 / $58.93 / $127.16	Facility		$36.24	$58.93	$127.16
Asuris Northwest Health Facility/Professional Facility Modifier CQ Low / Median / High Price $42.50 / $53.31 / $108.09	Facility	CQ	$42.50	$53.31	$108.09
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $26.58 / $47.08 / $226.20	Professional		$26.58	$47.08	$226.20
Asuris Northwest Health Facility/Professional Professional Modifier 52 Low / Median / High Price $13.33 / $13.33 / $13.33	Professional	52	$13.33	$13.33	$13.33
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 $24.76 / $56.87 / $104.88	Professional		$24.76	$56.87	$104.88
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $24.49 / $36.61 / $70.31	Facility		$24.49	$36.61	$70.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $22.72 / $36.08 / $66.19	Professional		$22.72	$36.08	$66.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.80 / $17.23 / $21.15	Professional		$14.80	$17.23	$21.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $41.00 / $53.60 / $56.95	Facility		$41.00	$53.60	$56.95
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $36.24 / $48.67 / $71.93	Facility		$36.24	$48.67	$71.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.26 / $50.85 / $67.84	Professional		$37.26	$50.85	$67.84
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $34.31 / $40.44 / $72.06	Facility		$34.31	$40.44	$72.06
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $26.27 / $27.95 / $46.56	Professional		$26.27	$27.95	$46.56
United Facility/Professional Professional Modifier Low / Median / High Price $23.09 / $28.87 / $74.97	Professional		$23.09	$28.87	$74.97
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $27.72 / $30.57 / $30.57	Professional		$27.72	$30.57	$30.57