| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $219.49 | $219.49 | $275.99 | |
Kaiser Permanente
| Professional | $393.93 | $393.93 | $11,260.00 | |
Lucent Health
| Facility | $167.54 | $424.02 | $424.02 | |
Lucent Health
| Professional | $525.55 | $525.55 | $525.55 |