| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $71.09 | $71.09 | $85.18 | |
Kaiser Permanente
| Professional | $89.00 | $393.93 | $801.00 | |
Lucent Health
| Facility | $130.55 | $198.53 | $293.31 | |
Lucent Health
| Professional | $388.19 | $803.55 | $803.55 | |
Providence
| Facility | $48.00 | $85.22 | $117.60 |