| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $34.43 | $34.43 | $41.25 | |
Kaiser Permanente
| Professional | $86.03 | $86.03 | $86.03 | |
Medcost
| Facility | $24.90 | $33.44 | $58.29 | |
Medcost
| Professional | $12.00 | $22.00 | $38.00 |