| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $187.61 | $224.77 | $270.63 | |
Kaiser Permanente
| Professional | $261.00 | $638.07 | $801.00 | |
Lucent Health
| Facility | $128.50 | $256.83 | $281.98 | |
Lucent Health
| Professional | $791.00 | $791.00 | $791.00 | |
Providence
| Facility | $101.28 | $157.05 | $246.71 |