| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $575.44 | $602.56 | $1,778.28 | |
Cigna
| Facility | AS | $177.83 | $177.83 | $177.83 |
Kaiser Permanente
| Professional | $870.96 | $1,148.15 | $1,584.89 | |
United
| Facility | $302.00 | $416.87 | $1,096.48 |