| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Facility | $199.53 | $199.53 | $338.84 | |
Pacific Source
| Facility | $11,481.54 | $11,481.54 | $11,481.54 |
Treatment/Observation Room - Other Treatment/Observation Rm
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Facility | $199.53 | $199.53 | $338.84 | |
Pacific Source
| Facility | $11,481.54 | $11,481.54 | $11,481.54 |