| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $55.95 | $55.95 | $67.03 | |
Kaiser Permanente
| Professional | $143.54 | $143.54 | $143.54 | |
Medcost
| Facility | $38.52 | $51.37 | $70.72 | |
Medcost
| Professional | $15.00 | $39.00 | $58.00 |