| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $356.79 | $356.79 | $356.79 |
Plmt Xtn Prosth Evasc Rpr Arysm/Dsj Ea Vsl
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $356.79 | $356.79 | $356.79 |