| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $200.00 | $239.00 | $239.00 | |
Kaiser Permanente
| Facility | $135.00 | $224.00 | $330.00 | |
Lucent Health
| Facility | $95.00 | $95.00 | $990.00 | |
Providence
| Facility | $200.00 | $239.00 | $239.00 |