| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $855.38 | $906.70 | $1,069.22 | |
Kaiser Permanente
| Professional | $393.93 | $638.07 | $801.00 | |
Lucent Health
| Facility | $90.00 | $90.00 | $90.00 | |
Lucent Health
| Professional | $1,676.48 | $2,849.18 | $2,849.18 |