| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $20.70 | $37.02 | $130.31 |
Cigna
| Facility | 26 | $26.51 | $26.51 | $26.51 |
Kaiser Permanente
| Professional | 26 | $22.09 | $26.51 | $52.76 |
Medcost
| Facility | 26 | $42.02 | $55.47 | $90.04 |