| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $2,145.00 | $4,604.00 | $9,274.00 | |
Kaiser Permanente
| Professional | $120.00 | $120.00 | $393.93 | |
Lucent Health
| Facility | $253.08 | $1,049.25 | $1,049.25 | |
Lucent Health
| Professional | $485.91 | $485.91 | $485.91 |