| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $376.69 | $376.69 | $602.70 | |
Aetna
| Professional | $150.50 | $376.69 | $376.69 | |
Asuris Northwest Health
| Facility | $703.65 | $959.75 | $1,856.73 | |
Pacific Source
| Facility | $511.00 | $820.00 | $79,999.20 | |
Regence BlueShield
| Facility | $670.87 | $959.75 | $1,835.89 |