| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,351.52 | $1,351.52 | $1,351.52 | |
Cigna
| Professional | $1,187.51 | $1,187.51 | $1,187.51 | |
Kaiser Permanente
| Professional | $139.41 | $139.41 | $139.41 | |
United
| Professional | $623.71 | $1,173.99 | $1,351.52 |