| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $187.61 | $224.77 | $270.63 | |
Kaiser Permanente
| Professional | $91.35 | $117.35 | $212.15 | |
Medcost
| Facility | $67.48 | $100.53 | $240.00 | |
Medcost
| Professional | $32.00 | $53.00 | $113.00 |