| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $380.19 | $524.81 | $676.08 | |
Cigna
| Facility | 52 | $26.30 | $26.30 | $26.30 |
Kaiser Permanente
| Professional | $14.13 | $18.62 | $28.18 | |
United
| Facility | $416.87 | $524.81 | $1,318.26 |