| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $506.99 | $643.88 | $1,077.79 | |
Kaiser Permanente
| Professional | $393.93 | $638.07 | $1,619.00 | |
Lucent Health
| Facility | $192.91 | $490.77 | $490.77 | |
Lucent Health
| Professional | $1,061.64 | $1,195.82 | $1,195.82 | |
Molina
| Professional | $85.00 | $85.00 | $85.00 |