| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $136.38 | $599.00 | $2,530.00 | |
Cigna
| Facility | AS | $13.27 | $13.27 | $13.27 |
Kaiser Permanente
| Professional | $116.67 | $147.10 | $199.86 | |
United
| Facility | $303.00 | $362.00 | $1,109.00 |