| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $929.40 | $1,076.15 | $1,956.64 | |
United
| Facility | $450.00 | $450.00 | $450.00 |
Exc Sac Pr Ulc Prepj Musc/Myoq Flap/Skn Grf Clsr
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $929.40 | $1,076.15 | $1,956.64 | |
United
| Facility | $450.00 | $450.00 | $450.00 |