| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $112.49 | $112.49 | $134.78 | |
Kaiser Permanente
| Professional | $393.93 | $638.07 | $801.00 | |
Lucent Health
| Facility | $211.87 | $298.45 | $420.38 | |
Lucent Health
| Professional | $583.55 | $583.55 | $583.55 |