| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $128.40 | $178.58 | $272.95 | |
Kaiser Permanente
| Professional | $393.93 | $638.07 | $1,619.00 | |
Lucent Health
| Facility | $118.35 | $303.87 | $303.87 | |
Lucent Health
| Professional | $381.57 | $396.65 | $396.65 | |
Providence
| Facility | $58.24 | $123.45 | $175.08 | |
Providence
| Professional | $123.99 | $123.99 | $123.99 |