| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $4.17 | $4.37 | $5.25 | |
Kaiser Permanente
| Professional | $128.82 | $398.11 | $831.76 | |
Lucent Health
| Facility | $3,801.89 | $3,801.89 | $3,801.89 | |
Lucent Health
| Professional | $489.78 | $549.54 | $549.54 |