| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $36.36 | $36.36 | $36.36 | |
Aetna
| Professional | $36.36 | $45.12 | $655.59 | |
Cigna
| Professional | $901.95 | $901.95 | $901.95 | |
Molina
| Professional | $30.00 | $45.00 | $60.00 | |
Regence BlueShield
| Professional | $107.57 | $554.97 | $923.83 | |
United
| Professional | $62.68 | $72.27 | $444.82 |