| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Asuris Northwest Health
| Facility | $191.20 | $268.57 | $268.57 | |
Asuris Northwest Health
| Professional | $264.00 | $264.00 | $264.00 | |
Cigna
| Professional | $59.97 | $59.97 | $75.41 | |
Pacific Source
| Facility | $57.33 | $75.98 | $93.84 |