| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $64.02 | $64.02 | $76.70 | |
Kaiser Permanente
| Professional | $165.08 | $165.08 | $165.08 | |
Medcost
| Facility | $46.50 | $64.25 | $85.54 | |
Medcost
| Professional | $22.00 | $47.00 | $73.00 |