| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $356.46 | $356.46 | $448.22 | |
Kaiser Permanente
| Professional | $393.93 | $393.93 | $1,619.00 | |
Lucent Health
| Facility | $78.20 | $670.71 | $670.71 | |
Lucent Health
| Professional | $852.67 | $852.67 | $852.67 | |
Providence
| Facility | $107.43 | $145.49 | $339.70 | |
Providence
| Professional | $357.51 | $357.51 | $357.51 |