| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $140.75 | $140.75 | $140.75 | |
Aetna
| Professional | $140.75 | $140.75 | $140.75 | |
Cigna
| Professional | $161.82 | $161.82 | $161.82 | |
Regence BlueShield
| Facility | $176.06 | $201.36 | $253.13 | |
United
| Professional | $137.26 | $163.26 | $173.38 |