| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,977.00 | $7,334.55 | $12,441.46 | |
Aetna
| Facility | 50 | $5,613.00 | $8,064.62 | $13,962.07 |
Regence BlueShield
| Facility | $10,361.94 | $13,564.50 | $19,767.36 | |
Regence BlueShield
| Facility | 50 | $15,542.91 | $20,346.75 | $29,651.04 |
United
| Facility | $3,028.00 | $9,753.00 | $15,824.00 |