| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $69.67 | $167.43 | $212.02 | |
Kaiser Permanente
| Professional | $139.37 | $257.77 | $801.00 | |
Lucent Health
| Facility | $65.00 | $142.56 | $535.67 | |
Lucent Health
| Professional | $628.44 | $1,070.79 | $1,070.79 |