| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Facility | $150.00 | $165.00 | $190.00 |
New Technology - Level 52 ($145,001-$160,000)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Facility | $150.00 | $165.00 | $190.00 |