| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $924.21 | $3,534.00 | $8,315.06 | |
Aetna
| Facility | 50 | $6,916.68 | $6,916.68 | $21,213.17 |
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 | $2,912.00 | $7,693.00 | $23,500.00 |