| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | QK | $194.98 | $194.98 | $263.03 |
Kaiser Permanente
| Professional | QX | $194.98 | $194.98 | $263.03 |
Kaiser Permanente
| Professional | QY | $194.98 | $194.98 | $263.03 |