| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $512.86 | $616.60 | $1,023.29 | |
Kaiser Permanente
| Professional | $141.25 | $630.96 | $1,698.24 | |
Lucent Health
| Facility | $1,071.52 | $1,071.52 | $1,071.52 | |
Lucent Health
| Professional | $1,479.11 | $1,479.11 | $1,621.81 | |
Providence
| Facility | $107.15 | $426.58 | $645.65 | |
Providence
| Professional | $467.74 | $467.74 | $467.74 |