| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $58.88 | $58.88 | $70.79 | |
Kaiser Permanente
| Professional | $151.36 | $151.36 | $151.36 | |
Medcost
| Professional | $50.12 | $63.10 | $63.10 | |
Medcost
| Facility | $41.69 | $58.88 | $91.20 |