| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $81.28 | $81.28 | $102.33 | |
Kaiser Permanente
| Professional | $398.11 | $398.11 | $1,698.24 | |
Lucent Health
| Facility | $251.19 | $251.19 | $346.74 | |
Lucent Health
| Professional | $870.96 | $870.96 | $870.96 | |
Providence
| Facility | $75.86 | $114.82 | $208.93 | |
Providence
| Professional | $100.00 | $100.00 | $100.00 |