| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $42.50 | $42.50 | $50.92 | |
Kaiser Permanente
| Professional | $106.52 | $106.52 | $106.52 | |
Medcost
| Facility | $31.78 | $43.14 | $75.56 | |
Medcost
| Professional | $14.00 | $27.00 | $48.00 |