| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $141.25 | $398.11 | $1,698.24 | |
Lucent Health
| Facility | $3,162.28 | $3,162.28 | $3,162.28 | |
Lucent Health
| Professional | $7,585.78 | $7,585.78 | $7,585.78 | |
Providence
| Facility | $309.03 | $1,230.27 | $1,778.28 | |
Providence
| Professional | $1,258.93 | $1,258.93 | $1,258.93 |