| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Asuris Northwest Health
| Facility | $104.00 | $185.61 | $253.72 | |
Asuris Northwest Health
| Professional | $483.00 | $483.00 | $483.00 | |
Cigna
| Professional | $101.52 | $215.08 | $272.36 | |
Pacific Source
| Facility | $77.42 | $104.80 | $113.56 |