| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Asuris Northwest Health
| Facility | $90.00 | $90.00 | $90.00 | |
Asuris Northwest Health
| Professional | $106.00 | $106.00 | $136.33 | |
Pacific Source
| Facility | $82.86 | $82.86 | $82.86 | |
Regence BlueShield
| Professional | $12.32 | $12.32 | $12.32 |