| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $170.00 | $170.00 | $178.00 | |
Pacific Source
| Facility | $79,999.20 | $79,999.20 | $79,999.20 | |
Providence
| Facility | $0.02 | $0.02 | $0.02 | |
Providence
| Professional | $0.02 | $0.02 | $2,400,000.00 |