| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1.13 | $1.13 | $1.13 | |
Aetna
| Professional | $1.11 | $1.13 | $2.68 | |
Asuris Northwest Health
| Facility | $4.20 | $8.25 | $100.00 | |
Asuris Northwest Health
| Professional | $1.87 | $2.64 | $3.71 | |
Cigna
| Professional | $1.74 | $1.74 | $1.74 | |
Molina
| Professional | $2.31 | $2.54 | $5.77 | |
Pacific Source
| Facility | $2.04 | $2.29 | $79,999.20 | |
Premera BCBS
| Facility | $4.20 | $5.64 | $8.25 |