| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Facility | $151.36 | $165.96 | $190.55 | |
Providence
| Facility | $3,162.28 | $3,162.28 | $3,162.28 |
New Technology - Level 16 ($1401 - $1500)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Facility | $151.36 | $165.96 | $190.55 | |
Providence
| Facility | $3,162.28 | $3,162.28 | $3,162.28 |