| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $53.73 | $57.32 | $69.33 | |
Anthem BCBS
| Professional | $51.55 | $57.28 | $121.44 | |
Kaiser Permanente
| Professional | $393.93 | $393.93 | $393.93 | |
Lucent Health
| Facility | $100.00 | $100.00 | $100.00 |