| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Premera BCBS
| Facility | $3,495.87 | $3,495.87 | $3,495.87 | |
Providence
| Facility | $3,495.87 | $3,495.87 | $3,495.87 | |
Providence
| Professional | $2,250,000.00 | $2,250,000.00 | $2,400,000.00 |