| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $2,143.00 | $4,576.00 | $9,589.00 | |
Kaiser Permanente
| Professional | $393.93 | $393.93 | $393.93 | |
Lucent Health
| Facility | $80.00 | $180.82 | $193.34 | |
Lucent Health
| Professional | $378.04 | $378.04 | $378.04 |