| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $199.53 | $239.88 | $239.88 | |
Kaiser Permanente
| Facility | $134.90 | $213.80 | $331.13 | |
Lucent Health
| Facility | $158.49 | $158.49 | $158.49 | |
Providence
| Facility | $199.53 | $199.53 | $239.88 |