| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $13.52 | $15.90 | $19.05 | |
Kaiser Permanente
| Professional | $20.00 | $638.07 | $801.00 | |
Lucent Health
| Facility | $55.00 | $85.00 | $90.00 | |
Lucent Health
| Professional | $40.97 | $47.85 | $57.99 |