| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $55.83 | $70.90 | $118.68 | |
Kaiser Permanente
| Professional | $22.04 | $22.04 | $801.00 | |
Lucent Health
| Facility | $76.04 | $243.60 | $243.60 | |
Lucent Health
| Professional | $201.00 | $201.00 | $201.00 | |
Providence
| Facility | $34.32 | $52.90 | $84.86 | |
Providence
| Professional | $59.53 | $59.53 | $59.53 |