| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $78.54 | $78.54 | $94.10 | |
Kaiser Permanente
| Professional | $235.13 | $235.13 | $235.13 | |
Medcost
| Facility | $51.44 | $81.12 | $109.76 | |
Medcost
| Professional | $28.61 | $36.00 | $73.00 |