| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $582.00 | $629.00 | $2,530.00 | |
Cigna
| Facility | AS | $176.72 | $176.72 | $176.72 |
Kaiser Permanente
| Professional | $1,551.56 | $1,964.17 | $2,660.27 | |
United
| Facility | $303.00 | $362.00 | $1,109.00 |