| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $51.33 | $57.07 | $61.47 | |
Asuris Northwest Health
| Professional | $19.80 | $19.80 | $175.00 | |
Cigna
| Facility | $28.52 | $50.96 | $57.99 | |
Cigna
| Professional | $15.02 | $15.02 | $15.02 | |
Molina
| Professional | $40.00 | $44.00 | $84.50 |