| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $37.15 | $37.15 | $46.77 | |
Kaiser Permanente
| Professional | $398.11 | $398.11 | $1,698.24 | |
Lucent Health
| Facility | $112.20 | $112.20 | $112.20 | |
Providence
| Facility | $16.22 | $20.42 | $70.79 | |
Providence
| Professional | $51.29 | $51.29 | $51.29 |