| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Facility | $150.00 | $165.00 | $190.00 | |
Providence
| Facility | $11,080.36 | $11,080.36 | $17,874.22 |
New Technology - Level 34 ($8001-$8500)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Facility | $150.00 | $165.00 | $190.00 | |
Providence
| Facility | $11,080.36 | $11,080.36 | $17,874.22 |