| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $158.90 | $158.90 | $352.98 | |
Aetna
| Professional | $158.90 | $158.90 | $158.90 | |
Cigna
| Facility | $86.43 | $88.90 | $278.63 | |
Cigna
| Professional | $46.50 | $108.50 | $185.12 | |
Regence BlueShield
| Facility | $101.12 | $116.29 | $409.54 | |
Regence BlueShield
| Professional | $105.39 | $112.03 | $178.52 | |
United
| Professional | $42.47 | $42.47 | $60.67 |