| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $80.93 | $103.75 | $424.34 |
Cigna
| Facility | 26 | $99.24 | $99.24 | $99.24 |
Kaiser Permanente
| Professional | 26 | $77.97 | $99.07 | $122.28 |
Medcost
| Facility | 26 | $97.76 | $122.00 | $234.90 |