| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $393.93 | $393.93 | $393.93 | |
Lucent Health
| Facility | $90.00 | $90.00 | $90.00 | |
Lucent Health
| Professional | $116.00 | $120.00 | $710.85 | |
Sutter Health Plus
| Professional | $73.09 | $73.09 | $84.02 |