| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $90.00 | $350.00 | $393.93 | |
Lucent Health
| Facility | $277.10 | $277.10 | $468.20 | |
Lucent Health
| Professional | $668.85 | $668.85 | $668.85 | |
United
| Professional | $152.88 | $248.43 | $363.09 |