| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Facility | $199.53 | $199.53 | $338.84 | |
Providence
| Facility | $16,982.44 | $25,703.96 | $70,794.58 |
Loa - Reserved
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Facility | $199.53 | $199.53 | $338.84 | |
Providence
| Facility | $16,982.44 | $25,703.96 | $70,794.58 |