| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | QK | $393.24 | $393.24 | $526.40 |
Kaiser Permanente
| Professional | QX | $393.24 | $393.24 | $526.40 |
Kaiser Permanente
| Professional | QY | $393.24 | $393.24 | $526.40 |