| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $128.37 | $672.66 | $881.90 | |
Aetna
| Professional | $128.37 | $128.37 | $128.37 | |
Cigna
| Facility | $121.91 | $125.39 | $393.00 | |
Cigna
| Professional | $171.16 | $171.16 | $171.16 | |
Molina
| Professional | $60.00 | $60.00 | $60.00 | |
Regence BlueShield
| Facility | $142.63 | $164.02 | $259.58 | |
Regence BlueShield
| Professional | $142.63 | $148.65 | $178.08 | |
United
| Professional | $59.90 | $59.90 | $85.58 |