| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $470.00 | $470.00 | $470.00 | |
Anthem BCBS
| Professional | $30.30 | $30.30 | $37.36 | |
Kaiser Permanente
| Professional | $120.00 | $393.93 | $1,619.00 | |
Lucent Health
| Facility | $55.00 | $70.00 | $1,646.16 | |
Lucent Health
| Professional | $153.00 | $155.88 | $227.67 | |
Molina
| Professional | $60.00 | $60.00 | $60.00 |