| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,033.06 | $6,374.00 | $13,762.00 | |
Aetna
| Facility | 50 | $3,105.83 | $6,031.02 | $21,504.04 |
Regence BlueShield
| Facility | $9,155.27 | $12,364.35 | $18,018.40 | |
Regence BlueShield
| Facility | 50 | $13,732.91 | $18,546.53 | $27,027.60 |
United
| Facility | $2,155.00 | $6,097.00 | $8,267.00 |