| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $205.88 | $205.88 | $257.33 | |
Kaiser Permanente
| Professional | $357.00 | $357.00 | $393.93 | |
Lucent Health
| Facility | $277.20 | $541.86 | $541.86 | |
Lucent Health
| Professional | $608.16 | $950.92 | $950.92 |