| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $3,222.00 | $7,303.00 | $15,399.00 | |
Kaiser Permanente
| Professional | $393.93 | $393.93 | $393.93 | |
Lucent Health
| Facility | $521.03 | $10,998.05 | $10,998.05 | |
Lucent Health
| Professional | $1,000.48 | $1,000.48 | $1,000.48 |