| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Regence BlueShield
| Facility | $1,250.00 | $1,250.00 | $1,250.00 |
Ungroupable
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Regence BlueShield
| Facility | $1,250.00 | $1,250.00 | $1,250.00 |