| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $402.69 | $3,084.00 | $4,707.00 | |
Regence BlueShield
| Facility | $1,715.47 | $2,237.48 | $3,260.64 | |
United
| Facility | $1,689.00 | $2,312.00 | $4,640.00 |
Colsc Flx W/Ndsc Us Xm Rctm Et Al Lmtd&Adj Strux
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $402.69 | $3,084.00 | $4,707.00 | |
Regence BlueShield
| Facility | $1,715.47 | $2,237.48 | $3,260.64 | |
United
| Facility | $1,689.00 | $2,312.00 | $4,640.00 |