| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $117.32 | $117.32 | $147.53 | |
Kaiser Permanente
| Professional | $393.93 | $393.93 | $11,260.00 | |
Lucent Health
| Facility | $164.08 | $518.70 | $518.70 | |
Lucent Health
| Professional | $505.54 | $510.52 | $510.52 |