| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $102.33 | $158.49 | $194.98 | |
Pacific Source
| Facility | $117.49 | $144.54 | $144.54 | |
Providence
| Professional | $44.67 | $44.67 | $44.67 | |
United
| Professional | $72.44 | $109.65 | $186.21 |