| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $23.44 | $23.44 | $29.51 | |
Contra Costa Health
| Professional | $100.00 | $100.00 | $100.00 | |
Kaiser Permanente
| Professional | $398.11 | $398.11 | $398.11 | |
Lucent Health
| Facility | $89.13 | $89.13 | $89.13 |