| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,555.44 | $7,245.00 | $15,004.00 | |
Aetna
| Facility | 50 | $2,796.61 | $4,416.68 | $18,102.00 |
Regence BlueShield
| Facility | $24,682.06 | $33,412.12 | $48,691.03 | |
Regence BlueShield
| Facility | 50 | $37,023.08 | $50,118.18 | $73,036.55 |
United
| Facility | $3,028.00 | $9,753.00 | $23,500.00 |