| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $84.49 | $84.49 | $84.49 | |
Aetna
| Professional | $84.49 | $84.49 | $109.84 | |
Cigna
| Professional | $92.77 | $92.77 | $92.77 | |
Regence BlueShield
| Facility | $116.80 | $142.80 | $171.46 | |
United
| Professional | $78.69 | $93.60 | $99.40 |