| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $28.22 | $30.61 | $36.67 | |
Kaiser Permanente
| Professional | $40.00 | $638.07 | $801.00 | |
Lucent Health
| Facility | $55.00 | $90.00 | $90.00 | |
Lucent Health
| Professional | $86.64 | $93.52 | $112.44 |