| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $185.58 | $193.14 | $1,096.25 |
Contra Costa Health
| Professional | 26 | $51.46 | $198.18 | $237.82 |
Kaiser Permanente
| Professional | 26 | $178.36 | $248.54 | $455.81 |
Lucent Health
| Facility | 26 | $1,325.36 | $1,660.64 | $1,693.28 |