| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $99.98 | $126.97 | $212.54 | |
Kaiser Permanente
| Professional | $51.30 | $77.00 | $801.00 | |
Lucent Health
| Facility | $109.75 | $1,791.30 | $1,791.30 | |
Lucent Health
| Professional | $385.00 | $385.00 | $385.00 | |
Providence
| Facility | $66.16 | $104.38 | $137.66 | |
Providence
| Professional | $108.52 | $108.52 | $108.52 |