| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Asuris Northwest Health
| Facility | $90.55 | $268.57 | $268.57 | |
Asuris Northwest Health
| Professional | $175.00 | $175.00 | $175.00 | |
Cigna
| Professional | $47.16 | $47.16 | $59.30 | |
Pacific Source
| Facility | $44.57 | $60.90 | $72.76 |