| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Asuris Northwest Health
| Facility | $745.39 | $745.39 | $745.39 | |
Pacific Source
| Facility | $79,999.20 | $79,999.20 | $79,999.20 | |
Pacific Source
| Professional | $1,256.60 | $1,256.60 | $1,256.60 |