| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $38.90 | $38.90 | $46.77 | |
Kaiser Permanente
| Professional | $102.33 | $102.33 | $102.33 | |
Medcost
| Professional | $33.88 | $42.66 | $42.66 | |
Medcost
| Facility | $27.54 | $38.90 | $57.54 |