| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $179.16 | $599.00 | $2,530.00 | |
Cigna
| Facility | AS | $17.41 | $17.41 | $17.41 |
Kaiser Permanente
| Professional | $149.96 | $189.93 | $266.58 | |
United
| Facility | $303.00 | $413.00 | $1,109.00 |