| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $164.42 | $164.42 | $164.42 | |
Aetna
| Professional | $164.42 | $164.42 | $164.42 | |
Cigna
| Professional | $219.62 | $219.62 | $219.62 | |
Regence BlueShield
| Facility | $182.98 | $226.11 | $255.93 | |
United
| Professional | $156.19 | $185.79 | $197.30 |