| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Asuris Northwest Health
| Facility | $128.50 | $235.00 | $256.83 | |
Asuris Northwest Health
| Professional | $791.00 | $791.00 | $791.00 | |
Cigna
| Professional | $100.88 | $213.72 | $270.63 | |
Pacific Source
| Facility | $77.04 | $103.49 | $119.68 |