| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $292.68 | $368.02 | $624.37 | |
Kaiser Permanente
| Professional | $727.89 | $727.89 | $727.89 | |
Medcost
| Facility | $199.72 | $264.30 | $378.85 | |
Medcost
| Professional | $24.00 | $35.00 | $273.00 |