| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $106.05 | $111.30 | $133.35 | |
Kaiser Permanente
| Professional | $638.07 | $638.07 | $801.00 | |
Molina
| Professional | $50.00 | $60.00 | $85.00 | |
Providence
| Professional | $16.00 | $35.00 | $40.00 |