| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Asuris Northwest Health
| Facility | $2,439.26 | $2,533.07 | $2,533.07 | |
Asuris Northwest Health
| Professional | $3,293.22 | $3,293.22 | $3,385.88 | |
Pacific Source
| Facility | $79,999.20 | $79,999.20 | $79,999.20 |