| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $5,863.00 | $15,025.00 | $29,048.00 | |
Kaiser Permanente
| Professional | $393.93 | $393.93 | $393.93 | |
Lucent Health
| Facility | $55.00 | $55.00 | $55.00 | |
Lucent Health
| Professional | $1,893.96 | $1,893.96 | $1,893.96 |