| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $34.47 | $36.17 | $43.34 | |
Kaiser Permanente
| Professional | $150.00 | $170.00 | $178.00 | |
Moda Health
| Professional | $48.60 | $51.84 | $58.24 | |
Pacific Source
| Facility | $60.75 | $79,999.20 | $79,999.20 |