| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $25.00 | $36.00 | $393.93 | |
Lucent Health
| Facility | $90.00 | $90.00 | $100.00 | |
Lucent Health
| Professional | $5.62 | $24.63 | $75.44 | |
Providence
| Professional | $25.81 | $25.81 | $26.98 | |
Sutter Health Plus
| Professional | $72.48 | $72.48 | $72.48 |