| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $582.00 | $629.00 | $2,530.00 | |
Cigna
| Facility | AS | $156.62 | $156.62 | $156.62 |
Kaiser Permanente
| Professional | $1,236.81 | $1,687.46 | $2,352.46 | |
United
| Facility | $717.00 | $964.00 | $2,489.00 |