| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Asuris Northwest Health
| Facility | $55.00 | $55.00 | $36,414.80 | |
Asuris Northwest Health
| Professional | $1,872.19 | $1,872.19 | $3,329.10 | |
Pacific Source
| Facility | $316.38 | $437.51 | $632.73 |