| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $303.44 | $391.44 | $645.28 |
Opn Ax/Subcla Art Expos Dlvr Evasc Prosth Uni
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $303.44 | $391.44 | $645.28 |