| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $4,108.00 | $9,596.00 | $18,150.00 | |
Kaiser Permanente
| Professional | $393.93 | $393.93 | $393.93 | |
Lucent Health
| Facility | $3,922.06 | $9,955.87 | $9,955.87 | |
Lucent Health
| Professional | $13,253.95 | $15,126.48 | $15,126.48 |