| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $2,456.00 | $6,191.00 | $14,393.00 | |
Kaiser Permanente
| Professional | $393.93 | $393.93 | $393.93 | |
Lucent Health
| Facility | $1,149.63 | $303,210.84 | $303,210.84 | |
Lucent Health
| Professional | $3,433.59 | $3,433.59 | $3,433.59 |