| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $4,528.00 | $11,697.00 | $21,510.00 | |
Kaiser Permanente
| Professional | $135.00 | $393.93 | $20,460.00 | |
Lucent Health
| Facility | $3,242.72 | $11,723.00 | $26,542.00 | |
Lucent Health
| Professional | $6,050.73 | $6,050.73 | $6,050.73 | |
Providence
| Facility | $1,471.80 | $1,831.79 | $2,594.62 |