| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Asuris Northwest Health
| Facility | $102.57 | $180.39 | $321.18 | |
Kaiser Permanente
| Facility | $171.09 | $171.09 | $171.09 | |
Kaiser Permanente
| Professional | $171.09 | $171.09 | $171.09 | |
Pacific Source
| Facility | $109.98 | $146.72 | $154.40 |