| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $123.03 | $123.03 | $151.36 | |
Kaiser Permanente
| Professional | $27.54 | $398.11 | $1,698.24 | |
Lucent Health
| Facility | $1,047.13 | $1,047.13 | $1,047.13 | |
Lucent Health
| Professional | $398.11 | $398.11 | $426.58 |