| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $9.40 | $20.00 | $32.79 | |
Asuris Northwest Health
| Facility | $90.00 | $100.00 | $100.00 | |
Asuris Northwest Health
| Professional | $15.16 | $21.26 | $147.85 | |
Cigna
| Professional | $8.50 | $8.50 | $8.50 | |
Molina
| Professional | $50.00 | $50.00 | $100.00 | |
Pacific Source
| Facility | $64.75 | $64.75 | $79,999.20 |