| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $287.98 | $287.98 | $362.11 | |
Kaiser Permanente
| Professional | $363.00 | $363.00 | $1,619.00 | |
Lucent Health
| Facility | $405.67 | $1,340.15 | $1,340.15 | |
Lucent Health
| Professional | $1,969.00 | $1,969.00 | $1,969.00 | |
Molina
| Professional | $85.00 | $85.00 | $85.00 |