| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $36.04 | $36.04 | $43.18 | |
Kaiser Permanente
| Professional | $90.27 | $90.27 | $90.27 | |
Medcost
| Facility | $26.07 | $35.46 | $62.44 | |
Medcost
| Professional | $12.00 | $22.00 | $40.00 |