| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $2,456.00 | $5,944.00 | $12,615.00 | |
Kaiser Permanente
| Professional | $120.00 | $120.00 | $393.93 | |
Lucent Health
| Facility | $748.86 | $10,710.95 | $10,710.95 | |
Lucent Health
| Professional | $1,436.79 | $1,436.79 | $1,436.79 |