| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $342.43 | $342.43 | $430.58 | |
Kaiser Permanente
| Professional | $393.93 | $393.93 | $1,619.00 | |
Lucent Health
| Facility | $481.80 | $3,616.95 | $3,616.95 | |
Lucent Health
| Professional | $1,429.00 | $1,429.00 | $1,429.00 | |
Molina
| Professional | $85.00 | $85.00 | $85.00 |