| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Premera BCBS
| Facility | $549.13 | $549.13 | $549.13 | |
Premera BCBS
| Professional | $128.37 | $128.37 | $128.37 | |
Providence
| Facility | $527.73 | $549.13 | $570.52 | |
Providence
| Professional | $392.23 | $392.23 | $392.23 |