| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $372.29 | $372.29 | $557.25 |
Kaiser Permanente
| Professional | 26 | $361.46 | $510.95 | $581.65 |
Pacific Source
| Facility | 26 | $357.21 | $440.31 | $481.00 |
Regence BlueShield
| Facility | 26 | $9,482.39 | $9,482.39 | $9,482.39 |