| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $40.68 | $40.68 | $40.68 | |
Aetna
| Professional | $40.68 | $40.68 | $40.68 | |
Cigna
| Facility | $111.63 | $136.50 | $432.14 | |
Molina
| Professional | $45.00 | $45.00 | $60.00 | |
Regence BlueShield
| Facility | $169.70 | $211.60 | $303.77 | |
Regence BlueShield
| Professional | $32.75 | $53.82 | $62.18 | |
United
| Professional | $40.42 | $45.11 | $75.00 |