| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $63.10 | $63.10 | $75.86 | |
Kaiser Permanente
| Professional | $158.49 | $158.49 | $158.49 | |
Medcost
| Professional | $58.88 | $74.13 | $74.13 | |
Medcost
| Facility | $47.86 | $66.07 | $100.00 |