| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Asuris Northwest Health
| Facility | $55.00 | $55.00 | $3,930.50 | |
Asuris Northwest Health
| Professional | $1,241.70 | $1,798.60 | $2,352.54 | |
Pacific Source
| Facility | $403.61 | $597.92 | $702.83 |