| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $111.86 | $120.21 | $657.11 |
Contra Costa Health
| Professional | 26 | $113.11 | $118.32 | $159.72 |
Kaiser Permanente
| Professional | 26 | $106.49 | $148.29 | $272.14 |
Lucent Health
| Facility | 26 | $249.44 | $505.63 | $533.04 |