| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $1,122.02 | $1,288.25 | $1,412.54 | |
Pacific Source
| Facility | $724.44 | $1,288.25 | $4,897.79 | |
Providence
| Facility | $1,659,586.91 | $1,659,586.91 | $1,659,586.91 | |
United
| Professional | $891.25 | $1,412.54 | $1,949.84 |