| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $15.14 | $30.20 | $109.65 |
Cigna
| Facility | 26 | $4.17 | $19.50 | $27.54 |
Kaiser Permanente
| Professional | 26 | $15.49 | $19.05 | $24.55 |
Medcost
| Professional | 26 | $25.12 | $31.62 | $37.15 |