| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $125.89 | $125.89 | $158.49 | |
Contra Costa Health
| Professional | $100.00 | $100.00 | $100.00 | |
Kaiser Permanente
| Professional | $398.11 | $398.11 | $398.11 | |
Lucent Health
| Facility | $281.84 | $281.84 | $281.84 | |
United
| Facility | $51.29 | $63.10 | $63.10 | |
United
| Professional | $36.31 | $51.29 | $218.78 |