| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $19.73 | $21.73 | $43.31 |
Kaiser Permanente
| Professional | 26 | $10.29 | $23.73 | $24.55 |
Pacific Source
| Facility | 26 | $14.30 | $17.42 | $20.77 |
Regence BlueShield
| Facility | 26 | $4,053.27 | $4,053.27 | $4,053.27 |