| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $23.71 | $43.45 | $103.68 |
Cigna
| Facility | 26 | $30.76 | $30.76 | $30.76 |
Kaiser Permanente
| Professional | 26 | $25.48 | $30.58 | $47.24 |
Medcost
| Facility | 26 | $40.74 | $45.00 | $73.56 |