| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $914.45 | $914.45 | $1,149.85 | |
Kaiser Permanente
| Professional | $393.93 | $393.93 | $9,238.00 | |
Lucent Health
| Facility | $609.92 | $5,563.56 | $5,563.56 | |
Lucent Health
| Professional | $4,522.00 | $4,522.00 | $4,522.00 | |
Providence
| Facility | $660.36 | $772.91 | $1,070.57 | |
Providence
| Professional | $803.77 | $803.77 | $803.77 |