| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $134.16 | $134.16 | $168.70 | |
Kaiser Permanente
| Professional | $393.93 | $393.93 | $1,619.00 | |
Lucent Health
| Facility | $169.38 | $435.24 | $435.24 | |
Lucent Health
| Professional | $802.00 | $919.93 | $919.93 | |
Providence
| Facility | $134.07 | $199.92 | $258.12 | |
Providence
| Professional | $131.78 | $131.78 | $131.78 |