| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $16.60 | $20.89 | $74.13 | |
Kaiser Permanente
| Professional | $128.82 | $398.11 | $831.76 | |
Lucent Health
| Facility | $147.91 | $147.91 | $147.91 | |
Lucent Health
| Professional | $158.49 | $158.49 | $158.49 |