| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | QK | $295.12 | $295.12 | $398.11 |
Kaiser Permanente
| Professional | QX | $295.12 | $295.12 | $398.11 |
Kaiser Permanente
| Professional | QY | $295.12 | $295.12 | $398.11 |