| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $129.21 | $154.81 | $186.46 | |
Kaiser Permanente
| Professional | $393.93 | $638.07 | $1,619.00 | |
Lucent Health
| Facility | $88.81 | $90.00 | $90.00 | |
Lucent Health
| Professional | $183.93 | $183.93 | $183.93 | |
Providence
| Facility | $33.13 | $33.13 | $33.13 | |
Sutter Health Plus
| Professional | $102.73 | $102.73 | $102.73 |