| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $663.67 | $3,038.00 | $4,897.22 | |
Aetna
| Facility | 50 | $17,953.91 | $17,953.91 | $17,953.91 |
Regence BlueShield
| Facility | $5,302.41 | $7,227.26 | $10,532.19 | |
Regence BlueShield
| Facility | 50 | $7,953.62 | $10,840.89 | $15,798.29 |
United
| Facility | $2,155.00 | $6,097.00 | $8,267.00 |