| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $59.17 | $59.17 | $70.90 | |
Kaiser Permanente
| Professional | $152.21 | $152.21 | $152.21 | |
Medcost
| Facility | $39.22 | $53.79 | $88.13 | |
Medcost
| Professional | $14.00 | $40.00 | $59.00 |