| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $107.15 | $112.20 | $134.90 | |
Kaiser Permanente
| Professional | $257.04 | $630.96 | $831.76 | |
Lucent Health
| Facility | $144.54 | $151.36 | $151.36 | |
Lucent Health
| Professional | $309.03 | $309.03 | $309.03 |