| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $77.03 | $2,922.00 | $4,387.00 | |
Aetna
| Professional | $77.03 | $87.61 | $533.38 | |
Molina
| Professional | $30.00 | $30.00 | $60.00 | |
Regence BlueShield
| Professional | $94.45 | $110.69 | $184.69 | |
United
| Facility | $1,078.00 | $1,556.00 | $4,495.00 | |
United
| Professional | $60.92 | $76.15 | $122.38 |