| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Asuris Northwest Health
| Facility | $100.00 | $100.00 | $100.00 | |
Molina
| Professional | $65.00 | $85.00 | $93.50 | |
Pacific Source
| Facility | $79,999.20 | $79,999.20 | $79,999.20 |
Noc For Parenteral Supplies
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Asuris Northwest Health
| Facility | $100.00 | $100.00 | $100.00 | |
Molina
| Professional | $65.00 | $85.00 | $93.50 | |
Pacific Source
| Facility | $79,999.20 | $79,999.20 | $79,999.20 |