| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $17.52 | $22.52 | $22.52 | |
Asuris Northwest Health
| Facility | $75.00 | $75.00 | $93.80 | |
Asuris Northwest Health
| Professional | $75.00 | $75.00 | $75.00 | |
Cigna
| Professional | $14.57 | $14.57 | $14.57 | |
Pacific Source
| Facility | $29.15 | $35.01 | $35.51 | |
United
| Professional | $22.26 | $22.79 | $27.64 |