| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $523.23 | $4,387.00 | $9,862.66 | |
Aetna
| Facility | 50 | $961.33 | $3,082.17 | $8,227.94 |
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 |