| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $3,242.00 | $7,362.00 | $15,399.00 | |
Kaiser Permanente
| Professional | $393.93 | $393.93 | $393.93 | |
Lucent Health
| Facility | $450.65 | $1,075.76 | $1,075.76 | |
Lucent Health
| Professional | $1,651.71 | $1,651.71 | $1,651.71 |