| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $4.37 | $4.37 | $5.24 | |
Kaiser Permanente
| Professional | $283.26 | $638.07 | $801.00 | |
Lucent Health
| Facility | $55.00 | $3,763.43 | $3,763.43 | |
Lucent Health
| Professional | $491.22 | $491.22 | $546.00 |