| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $1,448.52 | $1,448.52 | $1,448.52 | |
Pacific Source
| Facility | $909.70 | $1,108.18 | $1,108.18 | |
Providence
| Facility | $1,277.57 | $1,428.74 | $1,428.74 | |
Providence
| Professional | $720.27 | $1,332.00 | $1,531.80 |