| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $17.38 | $18.62 | $23.44 | |
Contra Costa Health
| Professional | $100.00 | $100.00 | $100.00 | |
Kaiser Permanente
| Professional | $38.90 | $38.90 | $398.11 | |
Lucent Health
| Facility | $89.13 | $89.13 | $89.13 | |
Sutter Health Plus
| Professional | $15.14 | $15.14 | $15.14 | |
United
| Facility | $6.92 | $8.32 | $8.32 | |
United
| Professional | $6.46 | $19.95 | $28.84 |