| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.32 | $35.17 | $48.18 | |
Aetna
| Professional | $19.21 | $20.32 | $220.00 | |
Asuris Northwest Health
| Professional | $360.00 | $388.00 | $400.00 | |
Molina
| Professional | $45.00 | $50.00 | $65.00 | |
Pacific Source
| Facility | $103.23 | $103.23 | $79,999.20 |