| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $79.00 | $79.00 | $79.00 | |
Aetna
| Professional | $79.00 | $79.00 | $79.00 | |
Regence BlueShield
| Facility | $387.98 | $563.88 | $809.54 | |
United
| Professional | $195.94 | $221.41 | $235.13 |