| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $11.67 | $16.23 | $24.81 | |
Kaiser Permanente
| Professional | $393.93 | $638.07 | $1,619.00 | |
Lucent Health
| Facility | $65.00 | $128.99 | $128.99 | |
Lucent Health
| Professional | $61.36 | $69.15 | $69.15 | |
Providence
| Facility | $12.14 | $19.32 | $26.71 | |
Providence
| Professional | $16.39 | $16.39 | $16.39 |