| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Asuris Northwest Health
| Facility | $55.00 | $55.00 | $1,697.00 | |
Asuris Northwest Health
| Professional | $1,438.25 | $1,438.25 | $1,438.25 | |
Pacific Source
| Facility | $278.10 | $384.58 | $430.50 |