Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $34.33 / $73.27 / $386.68	Facility		$34.33	$73.27	$386.68
Aetna Facility/Professional Facility Modifier CO Low / Median / High Price $141.85 / $141.85 / $800.69	Facility	CO	$141.85	$141.85	$800.69
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $59.44 / $97.55 / $286.14	Facility	CQ	$59.44	$97.55	$286.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.98 / $35.60 / $247.12	Professional		$14.98	$35.60	$247.12
Aetna Facility/Professional Professional Modifier CO Low / Median / High Price $106.23 / $106.23 / $152.00	Professional	CO	$106.23	$106.23	$152.00
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $47.10 / $106.36 / $210.06	Professional	CQ	$47.10	$106.36	$210.06
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $49.83 / $95.40 / $161.97	Facility		$49.83	$95.40	$161.97
Asuris Northwest Health Facility/Professional Facility Modifier CO Low / Median / High Price $42.71 / $65.76 / $137.66	Facility	CO	$42.71	$65.76	$137.66
Asuris Northwest Health Facility/Professional Facility Modifier CQ Low / Median / High Price $42.71 / $65.76 / $137.66	Facility	CQ	$42.71	$65.76	$137.66
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $35.15 / $64.02 / $310.35	Professional		$35.15	$64.02	$310.35
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 $36.11 / $61.50 / $107.04	Professional		$36.11	$61.50	$107.04
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $32.24 / $47.32 / $95.99	Facility		$32.24	$47.32	$95.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $32.47 / $49.23 / $88.77	Professional		$32.47	$49.23	$88.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.46 / $50.46 / $90.97	Professional		$9.46	$50.46	$90.97
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $46.55 / $67.31 / $75.04	Facility		$46.55	$67.31	$75.04
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $49.83 / $66.44 / $98.18	Facility		$49.83	$66.44	$98.18
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.77 / $69.69 / $92.24	Professional		$50.77	$69.69	$92.24
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $47.01 / $54.93 / $104.37	Facility		$47.01	$54.93	$104.37
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $36.04 / $37.95 / $63.22	Professional		$36.04	$37.95	$63.22
United Facility/Professional Professional Modifier Low / Median / High Price $29.42 / $40.42 / $105.44	Professional		$29.42	$40.42	$105.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $35.45 / $39.59 / $39.59	Professional		$35.45	$39.59	$39.59