| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $62.94 | $62.94 | $75.41 | |
Kaiser Permanente
| Professional | $160.05 | $160.05 | $160.05 | |
Medcost
| Facility | $45.58 | $63.47 | $94.05 | |
Medcost
| Professional | $21.00 | $40.00 | $69.00 |