| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $370.50 | $370.50 | $465.87 | |
Kaiser Permanente
| Professional | $113.30 | $363.00 | $1,550.00 | |
Lucent Health
| Facility | $562.01 | $1,340.15 | $1,340.15 | |
Lucent Health
| Professional | $1,344.06 | $1,344.06 | $1,344.06 | |
Molina
| Professional | $85.00 | $85.00 | $85.00 |