| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $223.87 | $269.15 | $446.68 | |
Kaiser Permanente
| Professional | $141.25 | $630.96 | $1,698.24 | |
Lucent Health
| Facility | $1,023.29 | $1,023.29 | $1,023.29 | |
Lucent Health
| Professional | $1,479.11 | $1,479.11 | $1,584.89 | |
Providence
| Facility | $104.71 | $389.05 | $616.60 | |
Providence
| Professional | $446.68 | $446.68 | $446.68 |