| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $37.47 | $67.79 | $101.12 | |
Kaiser Permanente
| Professional | $638.07 | $638.07 | $801.00 | |
Lucent Health
| Facility | $56.19 | $108.62 | $139.63 | |
Lucent Health
| Professional | $87.00 | $140.99 | $140.99 | |
Molina
| Professional | $85.00 | $85.00 | $85.00 |