| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Facility | $151.36 | $165.96 | $190.55 | |
Providence
| Facility | $2,187.76 | $2,187.76 | $2,187.76 |
Level 4 Diagnostic Tests and Related Services
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Facility | $151.36 | $165.96 | $190.55 | |
Providence
| Facility | $2,187.76 | $2,187.76 | $2,187.76 |