| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $906.42 | $906.42 | $906.42 | |
Aetna
| Professional | $435.35 | $861.86 | $906.42 | |
Molina
| Professional | $30.00 | $45.00 | $60.00 | |
Regence BlueShield
| Professional | $44.12 | $584.96 | $1,280.85 | |
United
| Professional | $192.14 | $1,105.20 | $1,670.39 |