| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $11.98 | $11.98 | $11.98 | |
Aetna
| Professional | $11.98 | $16.19 | $121.94 | |
Cigna
| Professional | $20.00 | $24.00 | $30.79 | |
Molina
| Professional | $30.00 | $45.00 | $80.00 | |
Regence BlueShield
| Professional | $64.50 | $64.50 | $64.50 | |
United
| Professional | $23.82 | $29.27 | $184.73 |