| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $141.25 | $186.21 | $281.84 | |
Kaiser Permanente
| Professional | $60.26 | $630.96 | $1,698.24 | |
Lucent Health
| Facility | $1,023.29 | $1,023.29 | $1,023.29 | |
Lucent Health
| Professional | $1,148.15 | $1,148.15 | $1,148.15 | |
Providence
| Facility | $125.89 | $229.09 | $346.74 | |
Providence
| Professional | $165.96 | $165.96 | $165.96 |