| 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 | $170.71 | $170.71 | $170.71 | |
Kaiser Permanente
| Professional | $12.82 | $12.82 | $12.82 | |
Molina
| Professional | $50.00 | $50.00 | $75.00 | |
Pacific Source
| Facility | $79,999.20 | $79,999.20 | $79,999.20 | |
United
| Professional | $199.56 | $199.56 | $239.47 |