| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Facility | $2,630.27 | $2,951.21 | $13,489.63 | |
Kaiser Permanente
| Professional | $2,344.23 | $2,951.21 | $5,011.87 | |
Pacific Source
| Facility | $4,168.69 | $6,309.57 | $6,309.57 | |
United
| Professional | $2,951.21 | $2,951.21 | $2,951.21 |