| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $894.94 | $1,992.87 | $2,388.12 | |
Pacific Source
| Facility | $79,999.20 | $79,999.20 | $79,999.20 | |
Providence
| Facility | $926.30 | $926.30 | $1,482.08 | |
Providence
| Professional | $926.30 | $926.30 | $926.30 | |
United
| Professional | $889.25 | $889.25 | $889.25 |