| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Asuris Northwest Health
| Facility | $55.00 | $55.00 | $7,459.40 | |
Asuris Northwest Health
| Professional | $4,230.00 | $4,230.00 | $4,230.00 | |
Pacific Source
| Facility | $551.85 | $741.65 | $806.47 |