| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $503.50 | $543.78 | $651.51 | |
Kaiser Permanente
| Professional | $1,664.53 | $1,664.53 | $1,664.53 | |
Medcost
| Facility | $399.00 | $399.00 | $758.10 | |
Medcost
| Professional | $875.00 | $875.00 | $875.00 |