| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $139.87 | $139.87 | $167.58 | |
Kaiser Permanente
| Professional | $356.87 | $356.87 | $356.87 | |
Medcost
| Facility | $109.91 | $165.51 | $405.42 | |
Medcost
| Professional | $40.00 | $134.00 | $203.00 |