| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Blue Shield
| Facility | $61.66 | $89.13 | $100.00 | |
Cigna
| Facility | $2,290.87 | $7,244.36 | $15,135.61 | |
HealthNet
| Facility | $1,949.84 | $26,302.68 | $46,773.51 | |
Kaiser Permanente
| Facility | $117.49 | $194.98 | $316.23 | |
Providence
| Facility | $1,819.70 | $6,760.83 | $15,135.61 |