| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Professional | $45.00 | $45.00 | $60.00 | |
Regence BlueShield
| Facility | $5,251.88 | $6,548.64 | $9,401.51 | |
Regence BlueShield
| Professional | $109.22 | $136.58 | $296.83 | |
United
| Professional | $103.29 | $137.72 | $337.95 |