| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $119.26 | $119.26 | $149.08 | |
Kaiser Permanente
| Professional | $393.93 | $393.93 | $1,619.00 | |
Lucent Health
| Facility | $197.00 | $444.15 | $444.15 | |
Lucent Health
| Professional | $728.00 | $728.00 | $728.00 |