| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $588.03 | $4,312.00 | $9,078.00 | |
Aetna
| Facility | 50 | $1,044.85 | $2,333.42 | $3,762.11 |
Regence BlueShield
| Facility | $9,633.73 | $12,977.17 | $18,911.45 | |
Regence BlueShield
| Facility | 50 | $14,450.60 | $19,465.75 | $28,367.18 |
United
| Facility | $2,155.00 | $6,097.00 | $8,267.00 |