| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $105.00 | $393.93 | $801.00 | |
Lucent Health
| Facility | $64.00 | $158.25 | $158.25 | |
Lucent Health
| Professional | $228.00 | $318.20 | $318.20 | |
Providence
| Facility | $40.10 | $62.00 | $93.07 |