| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $244.11 | $244.11 | $305.13 | |
Kaiser Permanente
| Professional | $393.93 | $393.93 | $1,619.00 | |
Lucent Health
| Facility | $780.34 | $1,834.53 | $2,025.75 | |
Lucent Health
| Professional | $5,807.00 | $5,807.00 | $5,807.00 | |
Providence
| Facility | $416.50 | $912.43 | $1,213.96 | |
Providence
| Professional | $376.05 | $376.05 | $376.05 |