| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $16.93 | $16.93 | $21.17 | |
Contra Costa Health
| Professional | $99.00 | $99.00 | $99.00 | |
Kaiser Permanente
| Professional | $393.93 | $393.93 | $1,619.00 | |
Lucent Health
| Facility | $90.00 | $90.00 | $100.00 | |
Providence
| Facility | $7.43 | $9.41 | $32.35 | |
Providence
| Professional | $23.34 | $23.34 | $23.34 |