| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $1,057.56 | $1,057.56 | $1,332.52 |
Regence BlueShield
| Professional | QX | $144.59 | $172.68 | $200.33 |
Regence BlueShield
| Professional | QY | $144.59 | $172.68 | $200.33 |