| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $31.20 | $55.86 | $213.87 |
Cigna
| Facility | 26 | $63.29 | $63.29 | $63.29 |
Kaiser Permanente
| Professional | 26 | $49.38 | $60.99 | $74.47 |
Medcost
| Facility | 26 | $49.85 | $57.00 | $132.36 |