| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Asuris Northwest Health
| Facility | $11,399.01 | $11,399.01 | $11,399.01 |
Urinary Stones W Esw Lithotripsy W Cc/Mcc
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Asuris Northwest Health
| Facility | $11,399.01 | $11,399.01 | $11,399.01 |