| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $101.02 | $101.02 | $101.02 | |
Aetna
| Professional | $37.11 | $101.02 | $111.39 | |
Cigna
| Professional | $83.40 | $83.40 | $83.40 | |
Molina
| Professional | $30.00 | $45.00 | $60.00 | |
Regence BlueShield
| Professional | $46.54 | $106.86 | $133.63 | |
United
| Professional | $89.32 | $120.12 | $164.34 |