| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $26.38 | $27.56 | $160.71 |
Contra Costa Health
| Professional | 26 | $9.06 | $28.75 | $38.81 |
Kaiser Permanente
| Professional | 26 | $23.77 | $34.50 | $60.74 |
Lucent Health
| Facility | 26 | $63.16 | $125.91 | $127.54 |