| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $815.24 | $4,387.00 | $8,802.00 | |
Aetna
| Facility | 50 | $2,110.48 | $2,110.48 | $2,110.48 |
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 |