| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $49.15 | $49.15 | $49.15 | |
Aetna
| Professional | $46.53 | $49.15 | $49.15 | |
Molina
| Professional | $45.00 | $45.00 | $60.00 | |
Regence BlueShield
| Facility | $58.21 | $72.58 | $104.20 | |
Regence BlueShield
| Professional | $52.00 | $65.03 | $74.63 | |
United
| Professional | $49.50 | $66.00 | $90.50 |