| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $297.52 | $297.52 | $374.11 | |
Kaiser Permanente
| Professional | $74.48 | $393.93 | $1,619.00 | |
Lucent Health
| Facility | $398.51 | $3,616.95 | $3,616.95 | |
Lucent Health
| Professional | $801.85 | $850.15 | $850.15 | |
Molina
| Professional | $85.00 | $85.00 | $85.00 |