| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $61.66 | $61.66 | $100.00 | |
United
| Professional | $66.07 | $107.15 | $204.17 | |
United
| Professional | 26 | $15.14 | $24.55 | $38.90 |
United
| Professional | TC | $51.29 | $83.18 | $177.83 |