| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $345.98 | $715.02 | $842.48 | |
Cigna
| Professional | $65.00 | $65.00 | $65.00 | |
Molina
| Professional | $30.00 | $30.00 | $3,900.00 | |
Regence BlueShield
| Facility | $484.26 | $663.71 | $904.47 |