| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $160.57 | $599.00 | $2,530.00 | |
Cigna
| Facility | AS | $15.62 | $15.62 | $15.62 |
Kaiser Permanente
| Professional | $136.81 | $172.51 | $258.95 | |
United
| Facility | $303.00 | $362.00 | $1,109.00 |