| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $252.84 | $252.84 | $302.93 | |
Kaiser Permanente
| Professional | $643.04 | $643.04 | $643.04 | |
Medcost
| Facility | $201.90 | $352.55 | $1,222.09 | |
Medcost
| Professional | $81.00 | $158.00 | $403.00 |