| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $40.35 | $40.35 | $48.34 | |
Kaiser Permanente
| Professional | $104.68 | $104.68 | $104.68 | |
Medcost
| Facility | $30.64 | $40.27 | $67.11 | |
Medcost
| Professional | $12.00 | $31.00 | $43.00 |