| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Asuris Northwest Health
| Facility | $55.00 | $55.00 | $10,014.09 | |
Asuris Northwest Health
| Professional | $31,534.00 | $31,534.00 | $31,534.00 | |
Pacific Source
| Facility | $3,555.26 | $4,519.93 | $4,927.85 |