| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $9.63 | $10.07 | $53.63 |
Contra Costa Health
| Professional | 26 | $5.24 | $11.56 | $15.61 |
Kaiser Permanente
| Professional | 26 | $9.50 | $13.81 | $24.22 |
Lucent Health
| Facility | 26 | $31.90 | $100.00 | $100.00 |