| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $758.58 | $758.58 | $954.99 | |
Kaiser Permanente
| Professional | $398.11 | $398.11 | $1,698.24 | |
Lucent Health
| Facility | $5,623.41 | $5,623.41 | $5,623.41 | |
Lucent Health
| Professional | $2,754.23 | $2,754.23 | $3,162.28 | |
Providence
| Facility | $371.54 | $512.86 | $724.44 | |
Providence
| Professional | $588.84 | $588.84 | $588.84 |