| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $316.81 | $316.81 | $379.57 | |
Kaiser Permanente
| Professional | $283.26 | $638.07 | $801.00 | |
Lucent Health
| Facility | $289.92 | $525.48 | $567.84 | |
Lucent Health
| Professional | $797.28 | $797.28 | $797.28 |