| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $50.24 | $63.81 | $106.81 | |
Kaiser Permanente
| Professional | $26.60 | $38.00 | $801.00 | |
Lucent Health
| Facility | $65.00 | $1,974.91 | $1,974.91 | |
Lucent Health
| Professional | $177.00 | $177.81 | $177.81 |