| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | QK | $245.47 | $245.47 | $331.13 |
Kaiser Permanente
| Professional | QX | $245.47 | $245.47 | $331.13 |
Kaiser Permanente
| Professional | QY | $245.47 | $245.47 | $331.13 |