| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $536.89 | $702.95 | $846.37 | |
Kaiser Permanente
| Professional | $393.93 | $638.07 | $801.00 | |
Lucent Health
| Facility | $80.00 | $116.67 | $200.00 | |
Lucent Health
| Professional | $228.13 | $228.13 | $228.13 | |
Molina
| Professional | $85.00 | $85.00 | $85.00 |