| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $37.72 | $67.09 | $160.02 |
Cigna
| Facility | 26 | $48.31 | $48.31 | $48.31 |
Kaiser Permanente
| Professional | 26 | $38.85 | $48.00 | $56.59 |
Medcost
| Facility | 26 | $54.00 | $60.26 | $125.79 |