| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $23.95 | $23.95 | $23.95 | |
Aetna
| Professional | $5.04 | $23.95 | $36.47 | |
Cigna
| Professional | $19.57 | $24.00 | $28.60 | |
Molina
| Professional | $30.00 | $45.00 | $80.00 | |
Regence BlueShield
| Professional | $28.50 | $28.50 | $28.50 | |
United
| Professional | $5.12 | $23.82 | $28.36 |