| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $24.55 | $24.55 | $30.20 | |
Kaiser Permanente
| Professional | $398.11 | $398.11 | $1,698.24 | |
Lucent Health
| Facility | $89.13 | $89.13 | $100.00 | |
Providence
| Facility | $10.72 | $13.80 | $41.69 | |
Providence
| Professional | $33.88 | $33.88 | $33.88 |