| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $46.69 | $59.30 | $99.26 | |
Kaiser Permanente
| Professional | $19.50 | $38.00 | $801.00 | |
Lucent Health
| Facility | $85.00 | $268.57 | $268.57 | |
Lucent Health
| Professional | $175.00 | $175.00 | $175.00 | |
Providence
| Facility | $30.40 | $50.38 | $63.75 | |
Providence
| Professional | $52.09 | $52.09 | $52.09 |