| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $68.45 | $73.22 | $294.97 |
Cigna
| Facility | 26 | $87.95 | $87.95 | $87.95 |
Kaiser Permanente
| Professional | 26 | $68.66 | $84.82 | $102.19 |
Medcost
| Facility | 26 | $104.46 | $125.27 | $233.02 |