| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $56.23 | $56.23 | $67.61 | |
Kaiser Permanente
| Professional | $144.54 | $144.54 | $144.54 | |
Medcost
| Professional | $42.66 | $53.70 | $53.70 | |
Medcost
| Facility | $35.48 | $53.70 | $79.43 |