| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Facility | $200.00 | $322.00 | $6,266.44 | |
Providence
| Facility | $15,555.00 | $24,298.98 | $35,173.12 |
Loa - Reserved
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Facility | $200.00 | $322.00 | $6,266.44 | |
Providence
| Facility | $15,555.00 | $24,298.98 | $35,173.12 |