| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $13.79 | $14.53 | $86.50 |
Contra Costa Health
| Professional | 26 | $3.22 | $15.29 | $20.64 |
Kaiser Permanente
| Professional | 26 | $12.56 | $18.30 | $32.09 |
Lucent Health
| Facility | 26 | $99.92 | $126.24 | $129.91 |