| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $239.88 | $575.44 | $630.96 | |
Cigna
| Facility | AS | $23.99 | $23.99 | $23.99 |
Kaiser Permanente
| Professional | $109.65 | $144.54 | $208.93 | |
United
| Facility | $302.00 | $380.19 | $1,096.48 |