| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $90.00 | $350.00 | $393.93 | |
Lucent Health
| Facility | $3,647.62 | $3,647.62 | $6,163.22 | |
Lucent Health
| Professional | $8,804.60 | $8,804.60 | $8,804.60 | |
Providence
| Professional | $2,767.16 | $2,767.16 | $2,892.94 | |
Sutter Health Plus
| Professional | $2,515.60 | $2,515.60 | $2,515.60 |