| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Asuris Northwest Health
| Facility | $275.82 | $621.92 | $621.92 | |
Asuris Northwest Health
| Professional | $781.72 | $875.23 | $875.23 | |
Cigna
| Professional | $151.72 | $151.72 | $190.78 | |
Pacific Source
| Facility | $180.23 | $249.24 | $334.56 |