| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $118.59 | $155.65 | $296.18 |
Cigna
| Facility | 26 | $97.61 | $97.61 | $97.61 |
Kaiser Permanente
| Professional | 26 | $76.19 | $94.11 | $114.89 |
Medcost
| Facility | 26 | $115.19 | $128.96 | $265.23 |