| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $165.52 | $165.52 | $181.91 | |
Kaiser Permanente
| Professional | $289.92 | $289.92 | $289.92 |
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $165.52 | $165.52 | $181.91 | |
Kaiser Permanente
| Professional | $289.92 | $289.92 | $289.92 |