| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $224.00 | $224.00 | $224.00 | |
Kaiser Permanente
| Facility | $100.00 | $136.00 | $302.00 | |
Lucent Health
| Facility | $95.00 | $95.00 | $990.00 | |
Providence
| Facility | $224.00 | $224.00 | $224.00 |