| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $240.00 | $240.00 | $240.00 | |
Aetna
| Professional | $240.00 | $240.00 | $269.76 | |
Asuris Northwest Health
| Facility | $55.00 | $55.00 | $55.00 | |
Asuris Northwest Health
| Professional | $75.00 | $75.00 | $75.00 | |
United
| Facility | $1,120.00 | $3,323.00 | $36,803.00 | |
United
| Professional | $294.89 | $411.38 | $710.39 |