| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $151.36 | $177.83 | $199.53 | |
Pacific Source
| Facility | $45.71 | $64.57 | $81.28 | |
Providence
| Facility | $1,659,586.91 | $1,659,586.91 | $1,659,586.91 | |
Providence
| Professional | $107.15 | $125.89 | $144.54 | |
United
| Professional | $91.20 | $144.54 | $204.17 |