| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $338.84 | $389.05 | $426.58 | |
Pacific Source
| Facility | $107.15 | $162.18 | $2,290.87 | |
Providence
| Facility | $1,659,586.91 | $1,659,586.91 | $1,659,586.91 | |
United
| Professional | $144.54 | $223.87 | $489.78 |