| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $19.05 | $30.90 | $36.31 |
Kaiser Permanente
| Professional | 26 | $26.30 | $30.20 | $37.15 |
Pacific Source
| Facility | 26 | $23.44 | $28.18 | $28.84 |
Providence
| Facility | 26 | $3.55 | $16.60 | $23.44 |
Regence BlueShield
| Facility | 26 | $776.25 | $776.25 | $776.25 |