| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $117.49 | $158.49 | $186.21 |
Kaiser Permanente
| Professional | 26 | $72.44 | $154.88 | $173.78 |
Pacific Source
| Facility | 26 | $114.82 | $144.54 | $144.54 |
Regence BlueShield
| Facility | 26 | $4,073.80 | $4,073.80 | $4,073.80 |