| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $680.94 | $5,743.00 | $11,692.00 | |
Aetna
| Facility | 50 | $6,267.29 | $6,267.29 | $6,553.66 |
Regence BlueShield
| Facility | $14,550.22 | $18,142.87 | $26,046.70 | |
Regence BlueShield
| Facility | 50 | $21,825.33 | $27,214.31 | $39,070.05 |
United
| Facility | $3,028.00 | $9,753.00 | $23,500.00 |