| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $251.48 | $251.48 | $362.69 | |
Kaiser Permanente
| Professional | $393.93 | $393.93 | $1,619.00 | |
Lucent Health
| Facility | $55.00 | $55.00 | $55.00 | |
Lucent Health
| Professional | $255.78 | $5,573.54 | $5,573.54 | |
Providence
| Facility | $106.59 | $106.59 | $115.50 |