| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $180.19 | $180.19 | $393.93 | |
Lucent Health
| Facility | $112.29 | $112.29 | $280.72 | |
Lucent Health
| Professional | $245.63 | $245.63 | $280.72 | |
Providence
| Professional | $74.04 | $77.20 | $105.27 |