| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Asuris Northwest Health
| Facility | $100.00 | $100.00 | $100.00 | |
Asuris Northwest Health
| Professional | $4.38 | $5.01 | $5.16 | |
Kaiser Permanente
| Facility | $0.80 | $0.80 | $1.20 | |
Kaiser Permanente
| Professional | $0.80 | $0.80 | $1.20 | |
Molina
| Professional | $50.00 | $50.00 | $80.00 | |
Pacific Source
| Facility | $79,999.20 | $79,999.20 | $79,999.20 | |
Wellpoint
| Professional | $50.00 | $50.00 | $50.00 |