| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $2,165.91 | $2,165.91 | $3,123.73 | |
Kaiser Permanente
| Professional | $500.00 | $4,750.00 | $17,033.14 | |
Lucent Health
| Facility | $55.00 | $3,257.32 | $5,753.88 | |
Lucent Health
| Professional | $15,341.00 | $15,341.00 | $15,341.00 | |
Providence
| Facility | $1,867.95 | $2,370.46 | $3,177.90 |