| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $56.23 | $75.86 | $114.82 | |
Kaiser Permanente
| Professional | $22.91 | $630.96 | $1,698.24 | |
Lucent Health
| Facility | $165.96 | $1,778.28 | $1,778.28 | |
Lucent Health
| Professional | $181.97 | $181.97 | $199.53 | |
Providence
| Facility | $37.15 | $53.70 | $77.62 | |
Providence
| Professional | $56.23 | $56.23 | $56.23 |