| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Asuris Northwest Health
| Facility | $55.00 | $55.00 | $4,176.81 | |
Asuris Northwest Health
| Professional | $10,745.00 | $11,462.87 | $11,462.87 | |
Pacific Source
| Facility | $1,745.17 | $2,271.10 | $2,457.09 |