| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Asuris Northwest Health
| Facility | $77.52 | $132.24 | $132.24 | |
Asuris Northwest Health
| Professional | $200.64 | $200.64 | $200.64 | |
Cigna
| Professional | $75.52 | $79.26 | $94.96 | |
Pacific Source
| Facility | $79,999.20 | $79,999.20 | $79,999.20 |