| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $204.42 | $254.25 | $409.97 | |
Kaiser Permanente
| Professional | $237.84 | $520.97 | $520.97 | |
Medcost
| Facility | $139.90 | $179.97 | $274.69 | |
Medcost
| Professional | $51.00 | $145.00 | $209.00 |