| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $23.05 | $41.82 | $99.27 |
Cigna
| Facility | 26 | $28.97 | $28.97 | $28.97 |
Kaiser Permanente
| Professional | 26 | $24.28 | $29.14 | $43.46 |
Medcost
| Facility | 26 | $39.27 | $44.00 | $69.51 |