Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $31.98 / $92.07 / $394.00	Facility		$31.98	$92.07	$394.00
Aetna Facility/Professional Facility Modifier CO Low / Median / High Price $65.89 / $93.84 / $162.71	Facility	CO	$65.89	$93.84	$162.71
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $22.16 / $38.71 / $52.80	Facility	CQ	$22.16	$38.71	$52.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.40 / $29.98 / $182.52	Professional		$14.40	$29.98	$182.52
Aetna Facility/Professional Professional Modifier CO Low / Median / High Price $47.18 / $47.18 / $47.18	Professional	CO	$47.18	$47.18	$47.18
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $28.48 / $28.48 / $83.79	Professional	CQ	$28.48	$28.48	$83.79
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $43.94 / $68.92 / $149.85	Facility		$43.94	$68.92	$149.85
Asuris Northwest Health Facility/Professional Facility Modifier CO Low / Median / High Price $42.50 / $61.71 / $127.37	Facility	CO	$42.50	$61.71	$127.37
Asuris Northwest Health Facility/Professional Facility Modifier CQ Low / Median / High Price $42.50 / $61.71 / $127.37	Facility	CQ	$42.50	$61.71	$127.37
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $32.27 / $56.99 / $275.18	Professional		$32.27	$56.99	$275.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $106.00 / $108.00 / $115.00	Facility		$106.00	$108.00	$115.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.73 / $60.80 / $105.64	Professional		$30.73	$60.80	$105.64
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $30.39 / $44.10 / $84.89	Facility		$30.39	$44.10	$84.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.38 / $44.10 / $81.09	Professional		$30.38	$44.10	$81.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.66 / $49.59 / $90.15	Professional		$9.66	$49.59	$90.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $47.50 / $64.98 / $66.33	Facility		$47.50	$64.98	$66.33
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $43.94 / $59.06 / $87.27	Facility		$43.94	$59.06	$87.27
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.18 / $61.52 / $82.25	Professional		$45.18	$61.52	$82.25
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $41.51 / $48.93 / $89.40	Facility		$41.51	$48.93	$89.40
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $31.87 / $33.81 / $56.33	Professional		$31.87	$33.81	$56.33
United Facility/Professional Professional Modifier Low / Median / High Price $27.22 / $35.01 / $85.87	Professional		$27.22	$35.01	$85.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $32.75 / $36.36 / $36.36	Professional		$32.75	$36.36	$36.36