| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $126.75 | $126.75 | $158.44 | |
Contra Costa Health
| Professional | $99.00 | $99.00 | $99.00 | |
Kaiser Permanente
| Professional | $350.00 | $350.00 | $393.93 | |
Lucent Health
| Facility | $165.92 | $165.92 | $165.92 | |
Providence
| Professional | $81.48 | $85.77 | $94.35 | |
United
| Professional | $51.46 | $80.09 | $80.09 |