| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $509.80 | $509.80 | $509.80 | |
Kaiser Permanente
| Professional | $283.26 | $638.07 | $801.00 | |
Lucent Health
| Facility | $515.79 | $515.79 | $515.79 | |
Lucent Health
| Professional | $749.70 | $749.70 | $749.70 |