| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Blue Shield
| Facility | $67.61 | $91.20 | $100.00 | |
Cigna
| Facility | $2,187.76 | $7,413.10 | $16,595.87 | |
HealthNet
| Facility | $2,754.23 | $2,754.23 | $2,754.23 | |
Kaiser Permanente
| Facility | $117.49 | $194.98 | $316.23 | |
Providence
| Facility | $1,659.59 | $6,760.83 | $19,054.61 |