| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $532.17 | $5,649.00 | $15,341.00 | |
Aetna
| Professional | $532.17 | $532.17 | $6,616.00 | |
Pacific Source
| Facility | $431.76 | $1,520.00 | $79,999.20 | |
Providence
| Facility | $2,400,000.00 | $2,400,000.00 | $2,400,000.00 | |
Providence
| Professional | $2,250,000.00 | $2,250,000.00 | $2,400,000.00 | |
Regence BlueShield
| Facility | $1,400.90 | $1,985.16 | $2,487.37 | |
United
| Facility | $376.00 | $3,290.00 | $6,216.00 |