| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $301.86 | $301.86 | $379.57 | |
Kaiser Permanente
| Professional | $393.93 | $393.93 | $393.93 | |
Lucent Health
| Facility | $311.66 | $1,555.30 | $1,555.30 | |
Lucent Health
| Professional | $797.28 | $797.28 | $797.28 |