| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Asuris Northwest Health
| Professional | $15.48 | $100.00 | $64,999.35 | |
Molina
| Professional | $50.00 | $50.00 | $80.00 | |
Pacific Source
| Facility | $79,999.20 | $79,999.20 | $79,999.20 | |
Wellpoint
| Professional | $750.00 | $750.00 | $750.00 |