| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $15.24 | $112.68 | $241.71 | |
Asuris Northwest Health
| Facility | $100.00 | $10,000.00 | $10,000.00 | |
Asuris Northwest Health
| Professional | $25.00 | $40.00 | $10,000.00 | |
Molina
| Professional | $50.00 | $50.00 | $75.00 | |
Premera BCBS
| Facility | $10,000.00 | $10,000.00 | $10,000.00 | |
Premera BCBS
| Professional | $10,000.00 | $10,000.00 | $10,000.00 |