| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $4,786.30 | $8,128.31 | $15,848.93 | |
Kaiser Permanente
| Professional | $398.11 | $398.11 | $1,698.24 | |
Lucent Health
| Facility | $54.95 | $56.23 | $3,890.45 | |
Lucent Health
| Professional | $3,630.78 | $3,630.78 | $3,630.78 |