| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $134.49 | $161.13 | $269.72 | |
Kaiser Permanente
| Professional | $43.10 | $638.07 | $801.00 | |
Lucent Health
| Facility | $163.31 | $489.68 | $489.68 | |
Lucent Health
| Professional | $371.46 | $433.18 | $433.18 | |
Sutter Health Plus
| Professional | $297.51 | $297.51 | $297.51 |