| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $90.00 | $350.00 | $393.93 | |
Lucent Health
| Facility | $255.48 | $255.48 | $431.67 | |
Lucent Health
| Professional | $616.66 | $616.66 | $616.66 | |
Providence
| Facility | $244.90 | $244.90 | $244.90 | |
Providence
| Professional | $193.81 | $193.81 | $220.24 |