| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $426.58 | $426.58 | $537.03 | |
Kaiser Permanente
| Professional | $398.11 | $398.11 | $398.11 | |
Lucent Health
| Facility | $1,698.24 | $1,698.24 | $1,698.24 | |
Lucent Health
| Professional | $1,698.24 | $1,698.24 | $1,949.84 | |
Providence
| Facility | $524.81 | $831.76 | $1,380.38 |