| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $36.68 | $47.17 | $47.17 | |
Asuris Northwest Health
| Facility | $75.00 | $75.00 | $196.49 | |
Asuris Northwest Health
| Professional | $75.00 | $75.00 | $75.00 | |
Cigna
| Professional | $30.52 | $30.52 | $30.52 | |
Pacific Source
| Facility | $61.05 | $73.33 | $74.37 | |
United
| Professional | $46.62 | $47.73 | $57.29 |