| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $35.15 | $39.97 | $80.83 |
Cigna
| Facility | 26 | $18.52 | $18.52 | $18.52 |
Kaiser Permanente
| Professional | 26 | $31.27 | $37.40 | $42.11 |
Pacific Source
| Facility | 26 | $23.74 | $31.44 | $32.83 |
Providence
| Facility | 26 | $18.52 | $18.52 | $18.52 |
Regence BlueShield
| Facility | 26 | $385.75 | $385.75 | $385.75 |