| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $401.37 | $401.37 | $504.69 | |
Kaiser Permanente
| Professional | $393.93 | $393.93 | $1,619.00 | |
Lucent Health
| Facility | $103.33 | $748.56 | $748.56 | |
Lucent Health
| Professional | $960.33 | $960.33 | $960.33 | |
Providence
| Facility | $112.72 | $147.11 | $382.88 | |
Providence
| Professional | $402.11 | $402.11 | $402.11 |