| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $140.94 | $140.94 | $168.87 | |
Kaiser Permanente
| Professional | $359.70 | $359.70 | $359.70 | |
Medcost
| Facility | $106.13 | $155.74 | $326.10 | |
Medcost
| Professional | $40.00 | $131.00 | $187.00 |