| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $2,143.00 | $4,952.00 | $10,705.00 | |
Kaiser Permanente
| Professional | $393.93 | $393.93 | $393.93 | |
Lucent Health
| Facility | $1,251.06 | $13,880.20 | $13,880.20 | |
Lucent Health
| Professional | $2,992.99 | $2,992.99 | $2,992.99 |