| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $26.51 | $26.51 | $31.77 | |
Kaiser Permanente
| Professional | $18.00 | $18.00 | $24.00 | |
Medcost
| Professional | $34.00 | $42.50 | $42.50 | |
Sentara
| Facility | $21.75 | $27.75 | $4,071.00 | |
Sentara
| Professional | $21.75 | $27.75 | $4,071.00 |