| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $225.08 | $2,833.00 | $4,387.00 | |
Aetna
| Facility | 53 | $45.02 | $45.02 | $91.44 |
Regence BlueShield
| Facility | $1,312.82 | $1,732.91 | $2,525.35 | |
Regence BlueShield
| Facility | 53 | $1,444.44 | $1,444.44 | $1,444.44 |
United
| Facility | $1,689.00 | $2,312.00 | $4,640.00 |