| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $12.30 | $12.30 | $14.79 | |
Kaiser Permanente
| Professional | $34.67 | $34.67 | $34.67 | |
Medcost
| Professional | $14.13 | $17.78 | $17.78 | |
Medcost
| Facility | $10.47 | $16.60 | $29.51 |