| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $20.82 | $21.79 | $126.44 |
Contra Costa Health
| Professional | 26 | $9.35 | $23.01 | $31.06 |
Kaiser Permanente
| Professional | 26 | $18.93 | $27.58 | $48.35 |
Lucent Health
| Facility | 26 | $61.36 | $108.00 | $108.00 |