| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Asuris Northwest Health
| Facility | $1,120.53 | $1,120.53 | $1,120.53 | |
Asuris Northwest Health
| Professional | $963.73 | $963.73 | $963.73 | |
Pacific Source
| Facility | $589.25 | $589.25 | $764.34 |