| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $49.49 | $49.49 | $59.30 | |
Kaiser Permanente
| Professional | $125.62 | $125.62 | $125.62 | |
Medcost
| Facility | $34.15 | $47.58 | $62.44 | |
Medcost
| Professional | $12.00 | $34.00 | $55.00 |