| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Asuris Northwest Health
| Facility | $55.00 | $55.00 | $3,658.83 | |
Asuris Northwest Health
| Professional | $4,286.49 | $4,286.49 | $5,352.35 | |
Pacific Source
| Facility | $1,266.97 | $1,706.90 | $1,878.84 |