| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $629.00 | $719.00 | $3,125.00 | |
Cigna
| Facility | AS | $71.77 | $71.77 | $71.77 |
Kaiser Permanente
| Professional | $633.00 | $806.76 | $1,079.50 | |
United
| Facility | $1,236.00 | $1,679.00 | $3,590.00 |