| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $51.29 | $69.18 | $104.71 | |
Kaiser Permanente
| Professional | $22.91 | $398.11 | $1,698.24 | |
Lucent Health
| Facility | $169.82 | $1,995.26 | $1,995.26 | |
Lucent Health
| Professional | $234.42 | $234.42 | $234.42 | |
Providence
| Facility | $42.66 | $61.66 | $85.11 | |
Providence
| Professional | $54.95 | $54.95 | $54.95 |