| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $27.76 | $32.39 | $65.48 |
Cigna
| Facility | 26 | $15.01 | $15.01 | $15.01 |
Kaiser Permanente
| Professional | 26 | $25.44 | $30.48 | $34.32 |
Pacific Source
| Facility | 26 | $20.09 | $25.46 | $27.47 |
Providence
| Facility | 26 | $15.01 | $15.01 | $15.01 |