| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $639.90 | $6,615.00 | $13,762.00 | |
Aetna
| Facility | 50 | $2,110.48 | $6,039.94 | $17,487.99 |
Regence BlueShield
| Facility | $10,361.94 | $13,564.50 | $19,767.36 | |
Regence BlueShield
| Facility | 50 | $15,542.91 | $20,346.75 | $29,651.04 |
United
| Facility | $2,912.00 | $7,693.00 | $13,847.00 |