| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $582.00 | $629.00 | $2,530.00 | |
Cigna
| Facility | AS | $131.97 | $131.97 | $131.97 |
Kaiser Permanente
| Professional | $1,161.81 | $1,422.30 | $1,982.51 | |
United
| Facility | $1,028.00 | $1,347.00 | $3,219.00 |