| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $35.29 | $35.29 | $35.29 | |
University Health Alliance
| Professional | $30.39 | $36.90 | $75.00 |
Breast prosthesis, mastectomy sleeve
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $35.29 | $35.29 | $35.29 | |
University Health Alliance
| Professional | $30.39 | $36.90 | $75.00 |