| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $257.04 | $457.09 | $891.25 | |
Lucent Health
| Facility | $95.50 | $95.50 | $95.50 | |
Lucent Health
| Professional | $1,071.52 | $1,071.52 | $1,288.25 | |
Sutter Health Plus
| Professional | $489.78 | $489.78 | $489.78 | |
United
| Professional | $52.48 | $52.48 | $52.48 |