| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | QK | $344.09 | $344.09 | $460.60 |
Kaiser Permanente
| Professional | QX | $344.09 | $344.09 | $460.60 |
Kaiser Permanente
| Professional | QY | $344.09 | $344.09 | $460.60 |