| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $728.62 | $728.62 | $872.97 | |
Kaiser Permanente
| Professional | $283.26 | $638.07 | $801.00 | |
Lucent Health
| Facility | $2,118.00 | $2,911.50 | $2,911.50 | |
Lucent Health
| Professional | $6,036.30 | $6,036.30 | $6,036.30 |