| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $28.88 | $28.88 | $36.09 | |
Kaiser Permanente
| Professional | $393.93 | $393.93 | $393.93 | |
Lucent Health
| Facility | $70.00 | $90.00 | $90.00 | |
Lucent Health
| Professional | $126.81 | $126.81 | $126.81 |