| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Facility | $150.00 | $165.00 | $190.00 | |
Providence
| Facility | $15,707.78 | $15,707.78 | $15,707.78 |
New Technology - Level 32 ($7001-$7500)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Facility | $150.00 | $165.00 | $190.00 | |
Providence
| Facility | $15,707.78 | $15,707.78 | $15,707.78 |