| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Blue Shield
| Facility | $82.20 | $93.00 | $330.00 | |
Cigna
| Facility | $2,315.00 | $6,763.00 | $14,971.00 | |
HealthNet
| Facility | $6,886.99 | $38,116.97 | $41,662.35 | |
Kaiser Permanente
| Facility | $118.50 | $195.00 | $315.00 | |
Providence
| Facility | $2,315.00 | $6,763.00 | $14,971.00 |