| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $53.72 | $92.89 | $225.83 |
Cigna
| Facility | 26 | $68.38 | $68.38 | $68.38 |
Kaiser Permanente
| Professional | 26 | $59.28 | $77.73 | $85.81 |
Medcost
| Facility | 26 | $69.61 | $73.00 | $179.86 |