| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $90.10 | $90.10 | $393.93 | |
Lucent Health
| Facility | $61.06 | $90.00 | $90.00 | |
Lucent Health
| Professional | $122.82 | $122.82 | $122.82 | |
Providence
| Professional | $37.02 | $38.60 | $52.64 |