| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $630.96 | $812.83 | $1,122.02 | |
Cigna
| Facility | AS | $112.20 | $112.20 | $112.20 |
Kaiser Permanente
| Professional | $549.54 | $724.44 | $1,023.29 | |
United
| Facility | $1,548.82 | $2,238.72 | $6,165.95 |