| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $58.84 | $107.06 | $246.34 |
Cigna
| Facility | 26 | $74.26 | $74.26 | $74.26 |
Kaiser Permanente
| Professional | 26 | $59.22 | $73.15 | $88.26 |
Medcost
| Facility | 26 | $95.72 | $109.00 | $197.92 |