| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $168.41 | $168.41 | $211.76 | |
Kaiser Permanente
| Professional | $27.55 | $393.93 | $1,619.00 | |
Lucent Health
| Facility | $168.25 | $1,035.15 | $1,035.15 | |
Lucent Health
| Professional | $429.80 | $429.80 | $429.80 | |
Molina
| Professional | $85.00 | $85.00 | $85.00 |