| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $92.62 | $92.62 | $116.47 | |
Kaiser Permanente
| Professional | $393.93 | $393.93 | $1,619.00 | |
Lucent Health
| Facility | $134.66 | $311.22 | $315.00 | |
Lucent Health
| Professional | $603.00 | $603.00 | $603.00 | |
Providence
| Facility | $96.44 | $146.61 | $206.55 | |
Providence
| Professional | $93.73 | $93.73 | $93.73 |