| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $48.82 | $87.31 | $204.87 |
Cigna
| Facility | 26 | $62.16 | $62.16 | $62.16 |
Kaiser Permanente
| Professional | 26 | $49.11 | $60.67 | $73.22 |
Medcost
| Facility | 26 | $90.66 | $98.00 | $181.14 |