| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $658.73 | $658.73 | $658.73 | |
Pacific Source
| Facility | $414.15 | $504.51 | $504.51 | |
Providence
| Facility | $650.44 | $650.44 | $2,400,000.00 | |
Providence
| Professional | $327.97 | $606.40 | $697.36 |