| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $231.29 | $4,387.00 | $9,907.00 | |
Aetna
| Facility | 50 | $859.06 | $2,439.90 | $6,881.00 |
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 | $1,981.00 | $3,613.00 | $7,048.00 |