| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $136.10 | $136.10 | $163.06 | |
Kaiser Permanente
| Professional | $344.17 | $344.17 | $344.17 | |
Medcost
| Facility | $81.17 | $119.52 | $141.78 | |
Medcost
| Professional | $56.00 | $86.00 | $143.00 |