| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $1,514.00 | $4,316.00 | $9,244.00 | |
Anthem BCBS
| Professional | $314.14 | $314.14 | $392.92 | |
Cigna
| Professional | $197.56 | $236.70 | $450.53 | |
Kaiser Permanente
| Professional | $257.77 | $638.07 | $801.00 | |
Lucent Health
| Facility | $55.00 | $322.86 | $555.23 | |
Lucent Health
| Professional | $365.00 | $1,480.40 | $1,480.40 |