| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $424.43 | $4,312.00 | $8,133.00 | |
Aetna
| Facility | 50 | $573.92 | $1,052.20 | $4,024.70 |
Regence BlueShield
| Facility | $4,525.68 | $6,104.56 | $8,896.10 | |
Regence BlueShield
| Facility | 50 | $6,788.54 | $9,156.84 | $13,344.15 |
United
| Facility | $1,981.00 | $3,613.00 | $7,048.00 |