| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Facility | $200.00 | $200.00 | $322.00 | |
Moda Health
| Facility | $0.28 | $0.28 | $3.99 |
Pharmacy - Drugs Incident to Radiology
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Facility | $200.00 | $200.00 | $322.00 | |
Moda Health
| Facility | $0.28 | $0.28 | $3.99 |