| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $41.96 | $41.96 | $50.27 | |
Kaiser Permanente
| Professional | $105.27 | $105.27 | $105.27 | |
Medcost
| Facility | $30.36 | $41.10 | $65.34 | |
Medcost
| Professional | $14.00 | $27.00 | $44.00 |