| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $110.00 | $155.00 | $393.93 | |
Lucent Health
| Facility | $100.00 | $120.00 | $200.00 | |
Lucent Health
| Professional | $165.00 | $165.00 | $165.00 | |
Providence
| Professional | $110.00 | $110.00 | $125.00 | |
Sutter Health Plus
| Professional | $227.00 | $227.00 | $227.00 |