| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $723.93 | $8,412.46 | $17,526.00 | |
Aetna
| Facility | 50 | $15,286.86 | $15,286.86 | $15,286.86 |
Regence BlueShield
| Facility | $8,370.62 | $10,940.20 | $15,943.01 | |
Regence BlueShield
| Facility | 50 | $12,555.93 | $16,410.30 | $23,914.52 |
United
| Facility | $3,028.00 | $9,753.00 | $15,824.00 |