| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $53.80 | $53.80 | $64.45 | |
Kaiser Permanente
| Professional | $133.79 | $133.79 | $133.79 | |
Medcost
| Facility | $34.09 | $48.27 | $101.66 | |
Medcost
| Professional | $19.69 | $25.00 | $49.00 |