| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $59.17 | $59.17 | $70.90 | |
Kaiser Permanente
| Professional | $152.63 | $152.63 | $152.63 | |
Medcost
| Facility | $41.45 | $56.30 | $84.14 | |
Medcost
| Professional | $20.00 | $39.00 | $63.00 |