| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Asuris Northwest Health
| Facility | $55.00 | $55.00 | $1,789.32 | |
Asuris Northwest Health
| Professional | $3,807.00 | $3,807.00 | $3,807.00 | |
Pacific Source
| Facility | $649.23 | $867.10 | $903.16 |