| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $398.11 | $398.11 | $2,884.03 | |
Lucent Health
| Facility | $7,079.46 | $7,079.46 | $7,079.46 | |
Lucent Health
| Professional | $13,182.57 | $13,182.57 | $13,182.57 | |
United
| Professional | $1,230.27 | $2,344.23 | $5,248.07 |