| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $582.00 | $629.00 | $2,530.00 | |
Cigna
| Facility | AS | $121.47 | $121.47 | $121.47 |
Kaiser Permanente
| Professional | $1,063.33 | $1,301.54 | $1,890.37 | |
United
| Facility | $303.00 | $413.00 | $1,109.00 |