| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $204.02 | $259.10 | $433.70 | |
Kaiser Permanente
| Professional | $73.91 | $73.91 | $801.00 | |
Lucent Health
| Facility | $305.88 | $477.72 | $477.72 | |
Lucent Health
| Professional | $625.42 | $684.55 | $684.55 | |
Molina
| Professional | $85.00 | $85.00 | $85.00 |