| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $2,143.00 | $4,958.00 | $13,459.00 | |
Kaiser Permanente
| Professional | $393.93 | $393.93 | $393.93 | |
Lucent Health
| Facility | $1,365.99 | $21,442.45 | $21,442.45 | |
Lucent Health
| Professional | $3,704.20 | $3,704.20 | $3,704.20 |