| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $114.82 | $114.82 | $141.25 | |
Kaiser Permanente
| Professional | $398.11 | $398.11 | $1,698.24 | |
Lucent Health
| Facility | $288.40 | $288.40 | $288.40 | |
Lucent Health
| Professional | $398.11 | $398.11 | $398.11 | |
Providence
| Facility | $43.65 | $74.13 | $158.49 | |
Providence
| Professional | $109.65 | $109.65 | $109.65 |