| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Blue Shield
| Facility | $61.30 | $87.50 | $122.00 | |
Cigna
| Facility | $35.00 | $35.00 | $244.00 | |
Kaiser Permanente
| Facility | $118.50 | $195.00 | $315.00 | |
Providence
| Facility | $35.00 | $35.00 | $244.00 |