| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $575.44 | $575.44 | $724.44 | |
Kaiser Permanente
| Professional | $398.11 | $398.11 | $1,698.24 | |
Lucent Health
| Facility | $3,630.78 | $3,630.78 | $3,630.78 | |
Lucent Health
| Professional | $1,819.70 | $1,819.70 | $1,819.70 |