| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $5,913.07 | $6,910.31 | $8,291.40 | |
Aetna
| Professional | $4,759.30 | $4,759.30 | $4,759.30 | |
Asuris Northwest Health
| Facility | $100.00 | $100.00 | $100.00 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 | |
Pacific Source
| Facility | $79,999.20 | $79,999.20 | $79,999.20 |