| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $114.82 | $234.42 | $363.08 | |
Kaiser Permanente
| Professional | $257.04 | $630.96 | $1,698.24 | |
Lucent Health
| Facility | $56.23 | $3,162.28 | $3,162.28 | |
Lucent Health
| Professional | $457.09 | $457.09 | $1,778.28 |