| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Facility | $151.36 | $165.96 | $190.55 | |
Providence
| Facility | $60,255.96 | $60,255.96 | $60,255.96 |
New Technology - Level 41 ($25,001-$30,000)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Facility | $151.36 | $165.96 | $190.55 | |
Providence
| Facility | $60,255.96 | $60,255.96 | $60,255.96 |