| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $393.93 | $393.93 | $1,619.00 | |
Lucent Health
| Facility | $215.29 | $354.12 | $354.12 | |
Lucent Health
| Professional | $445.87 | $445.87 | $445.87 | |
Providence
| Facility | $100.00 | $100.00 | $130.00 | |
Sutter Health Plus
| Professional | $249.60 | $249.60 | $249.60 |