| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $382.45 | $406.35 | $2,185.77 |
Contra Costa Health
| Professional | 26 | $376.31 | $396.54 | $535.33 |
Kaiser Permanente
| Professional | 26 | $356.89 | $497.23 | $912.04 |
Lucent Health
| Facility | 26 | $858.09 | $1,734.83 | $1,806.62 |