| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $27.11 | $137.41 | $164.64 | |
Kaiser Permanente
| Professional | $200.00 | $638.07 | $801.00 | |
Lucent Health
| Facility | $85.00 | $127.42 | $128.66 | |
Lucent Health
| Professional | $173.00 | $177.19 | $177.19 | |
Sutter Health Plus
| Professional | $131.12 | $131.12 | $131.12 | |
United
| Facility | $72.90 | $72.90 | $72.90 |