| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $273.83 | $599.00 | $2,530.00 | |
Cigna
| Facility | 52 | $213.26 | $213.26 | $213.26 |
Cigna
| Facility | AS | $26.66 | $26.66 | $26.66 |
Kaiser Permanente
| Professional | $233.61 | $294.70 | $400.46 | |
United
| Facility | $303.00 | $362.00 | $1,109.00 |