| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | QK | $270.35 | $270.35 | $361.90 |
Kaiser Permanente
| Professional | QX | $270.35 | $270.35 | $361.90 |
Kaiser Permanente
| Professional | QY | $270.35 | $270.35 | $361.90 |