| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $145.50 | $154.22 | $184.79 | |
Kaiser Permanente
| Professional | $393.93 | $638.07 | $801.00 | |
Lucent Health
| Facility | $1,117.73 | $2,015.58 | $2,015.58 | |
Lucent Health
| Professional | $3,048.26 | $3,048.26 | $3,048.26 |