| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $317.11 | $317.11 | $317.11 | |
Aetna
| Professional | $160.10 | $301.17 | $317.11 | |
Molina
| Professional | $30.00 | $45.00 | $60.00 | |
Regence BlueShield
| Professional | $106.52 | $224.64 | $448.13 | |
United
| Professional | $316.36 | $386.66 | $584.40 |