| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $159.41 | $200.45 | $340.07 | |
Kaiser Permanente
| Professional | $727.99 | $727.99 | $727.99 | |
Medcost
| Facility | $73.77 | $234.03 | $301.93 | |
Medcost
| Professional | $24.00 | $34.00 | $162.00 |