| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $128.00 | $670.72 | $879.36 | |
Aetna
| Professional | $128.00 | $128.00 | $128.00 | |
Cigna
| Facility | $170.95 | $175.82 | $551.07 | |
Cigna
| Professional | $240.00 | $240.00 | $240.00 | |
Molina
| Professional | $45.00 | $45.00 | $60.00 | |
Regence BlueShield
| Facility | $200.00 | $230.00 | $240.00 | |
Regence BlueShield
| Professional | $181.88 | $207.16 | $277.30 | |
United
| Professional | $84.00 | $84.00 | $120.00 |