| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Asuris Northwest Health
| Facility | $55.00 | $55.00 | $4,777.50 | |
Asuris Northwest Health
| Professional | $4,679.97 | $4,729.09 | $4,729.09 | |
Pacific Source
| Facility | $1,157.96 | $1,547.00 | $1,618.32 |