| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $93.34 | $116.68 | $147.13 | |
Contra Costa Health
| Professional | $99.00 | $99.00 | $99.00 | |
Kaiser Permanente
| Professional | $393.93 | $393.93 | $393.93 | |
Lucent Health
| Facility | $354.39 | $354.39 | $373.04 | |
Providence
| Professional | $76.47 | $85.80 | $93.26 |