| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $307.51 | $333.99 | $348.08 |
Contra Costa Health
| Professional | 26 | $353.90 | $389.29 | $460.07 |
Kaiser Permanente
| Professional | 26 | $318.51 | $442.38 | $771.50 |
Lucent Health
| Facility | 26 | $2,303.44 | $2,910.80 | $2,992.32 |