| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $741.31 | $891.25 | $977.24 | |
Pacific Source
| Facility | $575.44 | $691.83 | $707.95 | |
Providence
| Facility | $1,659,586.91 | $1,659,586.91 | $1,659,586.91 | |
United
| Professional | $426.58 | $501.19 | $1,047.13 |