| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $393.93 | $393.93 | $393.93 | |
Lucent Health
| Facility | $2,212.14 | $2,212.14 | $2,705.09 | |
Lucent Health
| Professional | $19,075.63 | $19,075.63 | $19,075.63 |