| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.41 | $0.41 | $0.41 | |
Aetna
| Professional | $0.39 | $0.41 | $1.47 | |
Asuris Northwest Health
| Facility | $2.50 | $4.92 | $100.00 | |
Asuris Northwest Health
| Professional | $1.06 | $1.14 | $1.99 | |
Cigna
| Professional | $0.88 | $0.88 | $0.88 | |
Pacific Source
| Facility | $0.80 | $0.80 | $79,999.20 | |
Premera BCBS
| Facility | $2.50 | $3.48 | $4.92 |