| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $309.03 | $309.03 | $389.05 | |
Kaiser Permanente
| Professional | $398.11 | $398.11 | $1,698.24 | |
Lucent Health
| Facility | $630.96 | $630.96 | $630.96 | |
Lucent Health
| Professional | $724.44 | $724.44 | $724.44 | |
Providence
| Facility | $89.13 | $162.18 | $302.00 | |
Providence
| Professional | $302.00 | $302.00 | $302.00 |