| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $31.62 | $31.62 | $39.81 | |
Kaiser Permanente
| Professional | $398.11 | $398.11 | $1,698.24 | |
Lucent Health
| Facility | $95.50 | $138.04 | $138.04 | |
Providence
| Facility | $13.80 | $18.20 | $42.66 | |
Providence
| Professional | $42.66 | $42.66 | $42.66 |