| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $395.74 | $395.74 | $395.74 | |
Pacific Source
| Facility | $248.60 | $302.83 | $302.83 | |
Providence
| Facility | $390.44 | $390.44 | $2,400,000.00 | |
Providence
| Professional | $197.06 | $364.00 | $418.60 |