| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Asuris Northwest Health
| Facility | $339.66 | $579.41 | $579.41 | |
Pacific Source
| Facility | $79,999.20 | $79,999.20 | $79,999.20 |
Hyaluronan or derivative, Visco-3, for intra-articular injection, per dose
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Asuris Northwest Health
| Facility | $339.66 | $579.41 | $579.41 | |
Pacific Source
| Facility | $79,999.20 | $79,999.20 | $79,999.20 |