| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Asuris Northwest Health
| Facility | $4,680.00 | $8,597.18 | $8,597.18 | |
Asuris Northwest Health
| Professional | $12,600.00 | $12,600.00 | $13,000.00 | |
Pacific Source
| Facility | $4,068.00 | $4,068.00 | $19,170.00 |