| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $125.34 | $125.34 | $150.16 | |
Kaiser Permanente
| Professional | $325.79 | $325.79 | $325.79 | |
Medcost
| Facility | $84.35 | $121.52 | $170.75 | |
Medcost
| Professional | $29.00 | $87.00 | $142.00 |