| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $398.11 | $630.96 | $831.76 | |
Lucent Health
| Facility | $295.12 | $295.12 | $295.12 | |
Lucent Health
| Professional | $295.12 | $295.12 | $295.12 | |
United
| Professional | $42.66 | $47.86 | $177.83 |