| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $31.80 | $31.80 | $38.10 | |
Kaiser Permanente
| Professional | $393.93 | $638.07 | $801.00 | |
Lucent Health
| Facility | $61.07 | $61.07 | $90.00 | |
Lucent Health
| Professional | $119.42 | $119.42 | $119.42 |