| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $778.01 | $4,387.00 | $8,393.90 | |
Aetna
| Facility | 50 | $2,790.82 | $2,790.82 | $2,790.82 |
Regence BlueShield
| Facility | $5,469.55 | $7,330.88 | $10,683.19 | |
Regence BlueShield
| Facility | 50 | $8,204.33 | $10,996.32 | $16,024.79 |
United
| Facility | $2,155.00 | $6,097.00 | $8,267.00 |