| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $1,071.52 | $1,318.26 | $10,715.19 | |
Pacific Source
| Facility | $6,309.57 | $7,585.78 | $10,000.00 | |
Providence
| Facility | $10,715.19 | $10,715.19 | $10,715.19 | |
Providence
| Professional | $1,023.29 | $7,943.28 | $11,481.54 | |
United
| Professional | $851.14 | $4,073.80 | $12,589.25 |