| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $430.64 | $430.64 | $541.50 | |
Kaiser Permanente
| Professional | $350.00 | $350.00 | $393.93 | |
Lucent Health
| Facility | $1,683.81 | $1,683.81 | $1,683.81 | |
Lucent Health
| Professional | $1,683.81 | $1,965.24 | $1,965.24 | |
Providence
| Facility | $577.44 | $940.56 | $1,360.19 |