| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $298.80 | $298.80 | $298.80 | |
Aetna
| Professional | $634.40 | $634.40 | $634.40 | |
Cigna
| Facility | $110.60 | $273.04 | $498.63 | |
Molina
| Professional | $30.00 | $32.34 | $3,900.00 | |
Regence BlueShield
| Facility | $156.94 | $217.32 | $319.48 |