| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $335.52 | $671.00 | $1,873.59 | |
Kaiser Permanente
| Professional | 26 | $82.22 | $154.33 | $329.28 |
Kaiser Permanente
| Professional | TC | $335.52 | $516.66 | $1,544.31 |
Oscar Health
| Professional | $67.64 | $293.22 | $507.43 |