| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $153.44 | $153.44 | $183.83 | |
Kaiser Permanente
| Professional | $283.26 | $638.07 | $801.00 | |
Lucent Health
| Facility | $183.87 | $709.90 | $709.90 | |
Lucent Health
| Professional | $486.76 | $629.84 | $629.84 | |
Molina
| Professional | $85.00 | $85.00 | $85.00 |