| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Asuris Northwest Health
| Facility | $102.11 | $268.57 | $268.57 | |
Asuris Northwest Health
| Professional | $242.00 | $242.00 | $242.00 | |
Cigna
| Professional | $59.97 | $59.97 | $75.41 | |
Pacific Source
| Facility | $57.33 | $78.39 | $96.56 |