| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $224.86 | $269.41 | $450.97 | |
Kaiser Permanente
| Professional | $393.93 | $638.07 | $801.00 | |
Lucent Health
| Facility | $645.21 | $1,022.73 | $1,022.73 | |
Lucent Health
| Professional | $1,462.74 | $1,577.03 | $1,577.03 | |
Providence
| Facility | $300.98 | $454.47 | $644.58 | |
Providence
| Professional | $450.42 | $450.42 | $450.42 |