| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $275.39 | $275.39 | $275.39 | |
Kaiser Permanente
| Professional | $283.26 | $638.07 | $801.00 | |
Lucent Health
| Facility | $278.64 | $1,416.70 | $1,416.70 | |
Lucent Health
| Professional | $405.00 | $405.00 | $405.00 |