| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.52 | $0.52 | $146.26 | |
Aetna
| Professional | $0.52 | $0.52 | $0.52 | |
Asuris Northwest Health
| Professional | $68.22 | $68.22 | $68.22 | |
Cigna
| Professional | $6.87 | $6.87 | $6.87 | |
Pacific Source
| Facility | $79,999.20 | $79,999.20 | $79,999.20 |