| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $50.75 | $64.45 | $107.89 | |
Kaiser Permanente
| Professional | $41.60 | $41.60 | $801.00 | |
Lucent Health
| Facility | $76.43 | $243.60 | $358.28 | |
Lucent Health
| Professional | $246.00 | $246.00 | $246.00 | |
Providence
| Facility | $35.58 | $55.09 | $103.59 | |
Providence
| Professional | $48.15 | $48.15 | $48.15 |