| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $3,908.00 | $9,168.00 | $16,991.00 | |
Kaiser Permanente
| Professional | $393.93 | $393.93 | $393.93 | |
Lucent Health
| Facility | $258.61 | $258.61 | $489.81 | |
Lucent Health
| Professional | $836.40 | $836.40 | $836.40 |