| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $89.13 | $89.13 | $398.11 | |
Lucent Health
| Facility | $436.52 | $436.52 | $436.52 | |
Lucent Health
| Professional | $794.33 | $794.33 | $794.33 | |
United
| Professional | $74.13 | $141.25 | $316.23 |