| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | QK | $98.31 | $98.31 | $131.60 |
Kaiser Permanente
| Professional | QX | $98.31 | $98.31 | $131.60 |
Kaiser Permanente
| Professional | QY | $98.31 | $98.31 | $131.60 |