| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,100.00 | $1,100.00 | $4,958.00 | |
Asuris Northwest Health
| Facility | $5,000.00 | $5,000.00 | $5,000.00 | |
United
| Facility | $1,084.00 | $1,084.00 | $1,084.00 |
Leave Of Absence - Patient Convenience
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,100.00 | $1,100.00 | $4,958.00 | |
Asuris Northwest Health
| Facility | $5,000.00 | $5,000.00 | $5,000.00 | |
United
| Facility | $1,084.00 | $1,084.00 | $1,084.00 |