| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $13.18 | $13.80 | $16.60 | |
Kaiser Permanente
| Professional | $104.71 | $281.84 | $831.76 | |
Lucent Health
| Facility | $229.09 | $229.09 | $229.09 | |
Lucent Health
| Professional | $1,513.56 | $1,513.56 | $1,513.56 |