| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $4,204.00 | $9,816.00 | $18,150.00 | |
Kaiser Permanente
| Professional | $393.93 | $393.93 | $393.93 | |
Lucent Health
| Facility | $70.00 | $90.00 | $90.00 | |
Lucent Health
| Professional | $90.55 | $90.55 | $90.55 |