| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $4,644.00 | $11,780.00 | $21,623.00 | |
Cigna
| Professional | $2,651.32 | $2,651.32 | $3,823.79 | |
Kaiser Permanente
| Professional | $393.93 | $393.93 | $1,619.00 | |
Lucent Health
| Facility | $55.00 | $3,531.63 | $6,333.72 | |
Lucent Health
| Professional | $9,730.00 | $9,730.00 | $9,730.00 |