| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Facility | $2,511.89 | $2,511.89 | $3,981.07 | |
Kaiser Permanente
| Professional | $2,238.72 | $2,511.89 | $4,265.80 | |
Pacific Source
| Facility | $3,801.89 | $3,801.89 | $3,981.07 |