| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $46.77 | $48.98 | $58.88 | |
Kaiser Permanente
| Professional | $128.82 | $630.96 | $831.76 | |
Lucent Health
| Facility | $331.13 | $331.13 | $331.13 | |
Lucent Health
| Professional | $407.38 | $407.38 | $407.38 |