| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $150.84 | $186.79 | $186.79 | |
Aetna
| Professional | $100.66 | $150.84 | $186.79 | |
Cigna
| Professional | $174.98 | $174.98 | $220.03 | |
Kaiser Permanente
| Professional | $393.93 | $638.07 | $801.00 | |
Lucent Health
| Facility | $267.85 | $358.86 | $369.63 | |
Lucent Health
| Professional | $433.05 | $433.05 | $433.05 |