| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $378.37 | $378.37 | $421.16 |
Cigna
| Facility | 26 | $193.73 | $193.73 | $193.73 |
Kaiser Permanente
| Professional | 26 | $299.33 | $389.68 | $438.74 |
Pacific Source
| Facility | 26 | $239.83 | $323.00 | $339.69 |
Providence
| Facility | 26 | $193.73 | $193.73 | $193.73 |