| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $17.48 | $20.96 | $73.34 | |
Kaiser Permanente
| Professional | $77.29 | $77.29 | $77.29 | |
Medcost
| Facility | $27.00 | $39.01 | $51.79 | |
Medcost
| Professional | $22.31 | $22.31 | $65.00 |