| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $575.44 | $602.56 | $5,248.07 | |
Cigna
| Facility | 22 | $6,309.57 | $6,309.57 | $6,309.57 |
Cigna
| Facility | AS | $524.81 | $524.81 | $524.81 |
Kaiser Permanente
| Professional | $2,511.89 | $3,311.31 | $4,677.35 | |
United
| Facility | $302.00 | $416.87 | $1,230.27 |