| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Asuris Northwest Health
| Facility | $128.37 | $677.49 | $677.49 | |
Asuris Northwest Health
| Professional | $159.75 | $710.30 | $1,069.73 | |
Kaiser Permanente
| Facility | $128.37 | $142.63 | $718.71 | |
Kaiser Permanente
| Professional | $128.37 | $142.63 | $356.58 | |
Molina
| Professional | $75.00 | $75.00 | $75.00 | |
Pacific Source
| Facility | $142.63 | $142.63 | $142.63 | |
Premera BCBS
| Facility | $128.37 | $128.37 | $142.63 | |
Premera BCBS
| Professional | $128.37 | $178.29 | $215.37 |