| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $115.66 | $115.66 | $138.57 | |
Kaiser Permanente
| Professional | $294.97 | $294.97 | $294.97 | |
Medcost
| Facility | $87.04 | $114.22 | $198.57 | |
Medcost
| Professional | $32.00 | $91.00 | $127.00 |