| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $173.78 | $173.78 | $218.78 | |
Kaiser Permanente
| Facility | $54.95 | $134.90 | $213.80 | |
Kaiser Permanente
| Professional | $54.95 | $138.04 | $229.09 | |
Molina
| Professional | $70.79 | $70.79 | $70.79 | |
Pacific Source
| Facility | $112.20 | $169.82 | $190.55 | |
United
| Professional | $81.28 | $102.33 | $186.21 |