| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $159.00 | $1,032.00 | $1,170.84 | |
Kaiser Permanente
| Facility | $118.50 | $195.00 | $350.00 | |
Lucent Health
| Facility | $735.00 | $735.00 | $735.00 |
MRT - Reserved
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $159.00 | $1,032.00 | $1,170.84 | |
Kaiser Permanente
| Facility | $118.50 | $195.00 | $350.00 | |
Lucent Health
| Facility | $735.00 | $735.00 | $735.00 |