| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $32.77 | $44.87 | $149.16 |
Cigna
| Facility | 26 | $30.82 | $30.82 | $30.82 |
Kaiser Permanente
| Professional | 26 | $25.64 | $30.77 | $61.02 |
Medcost
| Facility | 26 | $59.44 | $75.00 | $114.70 |