| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Facility | $200.00 | $200.00 | $322.00 | |
Moda Health
| Facility | $29.36 | $73.65 | $382.74 |
Medical/Surgical Supplies and Devices
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Facility | $200.00 | $200.00 | $322.00 | |
Moda Health
| Facility | $29.36 | $73.65 | $382.74 |