| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $688.70 | $3,038.00 | $7,568.00 | |
Aetna
| Facility | 50 | $1,892.66 | $3,579.16 | $9,632.33 |
Regence BlueShield
| Facility | $3,310.39 | $4,430.70 | $6,456.79 | |
Regence BlueShield
| Facility | 50 | $4,965.59 | $6,646.05 | $9,685.19 |
United
| Facility | $1,981.00 | $3,613.00 | $7,048.00 |