| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Facility | $30,199.52 | $109,647.82 | $257,039.58 | |
Kaiser Permanente
| Professional | $57,543.99 | $87,096.36 | $125,892.54 | |
Pacific Source
| Facility | $19,498.45 | $36,307.81 | $93,325.43 | |
United
| Professional | $380.19 | $380.19 | $380.19 |