| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1.00 | $52.94 | $52.94 | |
Asuris Northwest Health
| Facility | $80.00 | $132.00 | $132.00 | |
Asuris Northwest Health
| Professional | $75.00 | $85.00 | $64,999.35 | |
Cigna
| Professional | $50.00 | $64.97 | $84.89 | |
Molina
| Professional | $45.00 | $50.00 | $55.00 |