| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $4,528.00 | $11,697.00 | $21,510.00 | |
Kaiser Permanente
| Professional | $135.00 | $393.93 | $393.93 | |
Lucent Health
| Facility | $383.91 | $383.91 | $726.91 | |
Lucent Health
| Professional | $1,241.42 | $1,241.42 | $1,241.42 |