| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $582.00 | $629.00 | $3,529.97 | |
Cigna
| Facility | AS | $346.01 | $346.01 | $346.01 |
Kaiser Permanente
| Professional | $3,031.85 | $3,847.69 | $5,218.74 | |
United
| Facility | $303.00 | $362.00 | $1,109.00 |