| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $124.27 | $148.88 | $179.27 | |
Kaiser Permanente
| Professional | $67.52 | $139.60 | $525.00 | |
Medcost
| Facility | $43.94 | $56.81 | $142.19 | |
Medcost
| Professional | $47.00 | $56.00 | $67.00 |