| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Asuris Northwest Health
| Facility | $2,304.73 | $2,393.39 | $2,393.39 | |
Asuris Northwest Health
| Professional | $3,111.60 | $3,111.60 | $3,199.16 | |
Pacific Source
| Facility | $79,999.20 | $79,999.20 | $79,999.20 |