| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,174.90 | $1,412.54 | $3,630.78 | |
HealthNet
| Facility | $1,995.26 | $6,165.95 | $12,882.50 | |
Kaiser Permanente
| Facility | $199.53 | $199.53 | $338.84 | |
Pacific Source
| Facility | $75.86 | $346.74 | $912.01 | |
Providence
| Facility | $1,174.90 | $1,412.54 | $3,630.78 |