| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,894.41 | $5,743.00 | $16,054.56 | |
Regence BlueShield
| Facility | $10,147.96 | $12,655.20 | $18,168.36 | |
Regence BlueShield
| Facility | 50 | $15,221.96 | $18,982.80 | $27,252.54 |
United
| Facility | $2,912.00 | $7,693.00 | $13,847.00 |