| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Asuris Northwest Health
| Facility | $154.00 | $1,524.13 | $1,524.13 | |
Asuris Northwest Health
| Professional | $5,807.00 | $5,807.00 | $5,807.00 | |
Pacific Source
| Facility | $668.96 | $668.96 | $668.96 |