| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $582.00 | $629.00 | $4,013.89 | |
Cigna
| Facility | 62 | $2,448.96 | $2,448.96 | $2,448.96 |
Cigna
| Facility | AS | $391.83 | $391.83 | $391.83 |
Kaiser Permanente
| Professional | $3,395.30 | $4,219.05 | $5,917.34 | |
United
| Facility | $303.00 | $362.00 | $1,109.00 |