| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $68.52 | $68.52 | $152.19 | |
Aetna
| Professional | $68.52 | $68.52 | $68.52 | |
Cigna
| Facility | $54.66 | $56.22 | $176.22 | |
Cigna
| Professional | $29.34 | $68.59 | $116.82 | |
Regence BlueShield
| Facility | $63.96 | $73.55 | $259.04 | |
Regence BlueShield
| Professional | $66.66 | $70.87 | $76.61 | |
United
| Professional | $26.86 | $26.86 | $38.38 |