| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $79.26 | $79.26 | $94.96 | |
Kaiser Permanente
| Professional | $283.26 | $638.07 | $801.00 | |
Lucent Health
| Facility | $77.52 | $132.24 | $132.24 | |
Lucent Health
| Professional | $200.64 | $200.64 | $200.64 |