| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Asuris Northwest Health
| Facility | $55.00 | $55.00 | $4,067.94 | |
Asuris Northwest Health
| Professional | $8,306.09 | $8,306.09 | $8,306.09 | |
Pacific Source
| Facility | $1,458.35 | $2,016.70 | $2,386.80 |