| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Asuris Northwest Health
| Professional | $50.00 | $50.00 | $50.00 | |
Molina
| Professional | $50.00 | $50.00 | $50.00 | |
Pacific Source
| Facility | $79,999.20 | $79,999.20 | $79,999.20 |
Hemophilia clotting factor, not otherwise classified
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Asuris Northwest Health
| Professional | $50.00 | $50.00 | $50.00 | |
Molina
| Professional | $50.00 | $50.00 | $50.00 | |
Pacific Source
| Facility | $79,999.20 | $79,999.20 | $79,999.20 |