| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $42.14 | $42.14 | $50.48 | |
Kaiser Permanente
| Professional | $165.00 | $165.00 | $222.00 | |
Oscar Health
| Facility | $53.48 | $53.48 | $53.48 | |
Oscar Health
| Professional | $73.00 | $111.89 | $137.99 |