| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $12.88 | $22.88 | $54.01 |
Cigna
| Facility | 26 | $16.57 | $16.57 | $16.57 |
Kaiser Permanente
| Professional | 26 | $12.96 | $16.01 | $19.32 |
Medcost
| Facility | 26 | $20.00 | $21.71 | $43.63 |