| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $141.25 | $141.25 | $398.11 | |
Lucent Health
| Facility | $371.54 | $371.54 | $371.54 | |
Lucent Health
| Professional | $371.54 | $371.54 | $371.54 | |
United
| Professional | $53.70 | $53.70 | $61.66 |