| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $51.64 | $51.64 | $61.87 | |
Kaiser Permanente
| Professional | $129.66 | $129.66 | $129.66 | |
Medcost
| Facility | $39.10 | $53.39 | $90.42 | |
Medcost
| Professional | $17.00 | $34.00 | $59.00 |