| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Blue Shield
| Facility | $82.20 | $90.30 | $186.00 | |
Cigna
| Facility | $2,091.00 | $6,763.00 | $16,441.00 | |
HealthNet
| Facility | $130.00 | $130.00 | $130.00 | |
Kaiser Permanente
| Facility | $118.50 | $195.00 | $315.00 | |
Providence
| Facility | $1,665.00 | $6,763.00 | $19,176.00 |