| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $93.42 | $93.42 | $93.42 | |
Aetna
| Professional | $55.74 | $93.42 | $102.92 | |
Cigna
| Professional | $21.97 | $23.06 | $27.62 | |
Molina
| Professional | $30.00 | $45.00 | $80.00 | |
Regence BlueShield
| Professional | $59.29 | $98.83 | $131.12 | |
United
| Professional | $75.00 | $113.99 | $171.01 |