| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $295.12 | $371.54 | $630.96 | |
Kaiser Permanente
| Professional | $724.44 | $724.44 | $724.44 | |
Medcost
| Professional | $245.47 | $309.03 | $309.03 | |
Medcost
| Facility | $33.88 | $269.15 | $398.11 |