| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $89.13 | $89.13 | $398.11 | |
Lucent Health
| Facility | $467.74 | $467.74 | $467.74 | |
Lucent Health
| Professional | $851.14 | $851.14 | $851.14 | |
United
| Professional | $79.43 | $151.36 | $346.74 |