| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | QK | $512.86 | $512.86 | $691.83 |
Kaiser Permanente
| Professional | QX | $512.86 | $512.86 | $691.83 |
Kaiser Permanente
| Professional | QY | $512.86 | $512.86 | $691.83 |