| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $141.38 | $149.86 | $179.55 | |
Kaiser Permanente
| Professional | $103.00 | $638.07 | $801.00 | |
Lucent Health
| Facility | $224.62 | $423.00 | $423.00 | |
Lucent Health
| Professional | $470.80 | $583.46 | $583.46 |