| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $4,108.00 | $9,830.00 | $19,951.00 | |
Kaiser Permanente
| Professional | $393.93 | $393.93 | $393.93 | |
Lucent Health
| Facility | $13,534.86 | $59,255.65 | $59,255.65 | |
Lucent Health
| Professional | $13,534.86 | $13,534.86 | $13,915.67 |