| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Asuris Northwest Health
| Facility | $55.00 | $1,024.71 | $1,024.71 | |
Asuris Northwest Health
| Professional | $1,138.00 | $1,138.00 | $1,138.00 | |
Cigna
| Professional | $133.27 | $133.27 | $167.58 |