| 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 | $1,911.03 | $1,911.03 | $2,756.14 | |
Kaiser Permanente
| Professional | $500.00 | $4,750.00 | $17,033.14 | |
Lucent Health
| Facility | $55.00 | $55.00 | $5,682.77 | |
Lucent Health
| Professional | $15,682.00 | $15,682.00 | $15,682.00 | |
Providence
| Facility | $1,732.90 | $2,186.94 | $3,248.52 |