| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $769.91 | $4,312.00 | $8,344.00 | |
Aetna
| Facility | 50 | $6,744.47 | $6,744.47 | $6,744.47 |
Regence BlueShield
| Facility | $5,209.35 | $7,100.42 | $10,347.35 | |
Regence BlueShield
| Facility | 50 | $7,814.03 | $10,650.63 | $15,521.03 |
United
| Facility | $871.00 | $4,912.00 | $7,373.90 |