| 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 | $2,870.52 | $2,870.52 | $4,139.92 | |
Kaiser Permanente
| Professional | $393.93 | $393.93 | $1,619.00 | |
Lucent Health
| Facility | $55.00 | $55.00 | $6,919.50 | |
Lucent Health
| Professional | $8,793.54 | $8,793.54 | $8,793.54 | |
Providence
| Facility | $1,837.50 | $2,372.48 | $3,214.39 |