| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $94.88 | $599.00 | $2,530.00 | |
Cigna
| Facility | AS | $9.25 | $9.25 | $9.25 |
Kaiser Permanente
| Professional | $81.16 | $102.42 | $151.82 | |
United
| Facility | $76.00 | $100.00 | $550.00 |