| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Asuris Northwest Health
| Facility | $960.00 | $1,376.68 | $2,400.00 | |
Asuris Northwest Health
| Professional | $3,160.00 | $3,160.00 | $3,200.00 | |
Cigna
| Professional | $915.84 | $915.84 | $1,097.28 | |
Pacific Source
| Facility | $848.00 | $848.00 | $79,999.20 |