| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $105.98 | $105.98 | $126.97 | |
Kaiser Permanente
| Professional | $270.83 | $270.83 | $270.83 | |
Medcost
| Facility | $74.58 | $99.50 | $133.19 | |
Medcost
| Professional | $33.00 | $72.00 | $111.00 |