| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $75.86 | $79.43 | $95.50 | |
Kaiser Permanente
| Professional | $128.82 | $398.11 | $831.76 | |
Lucent Health
| Facility | $131.83 | $131.83 | $131.83 | |
Lucent Health
| Professional | $407.38 | $407.38 | $407.38 |