| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $191.92 | $191.92 | $191.92 | |
Aetna
| Professional | $191.92 | $191.92 | $191.92 | |
Cigna
| Professional | $188.55 | $188.55 | $188.55 | |
Regence BlueShield
| Facility | $191.09 | $211.83 | $211.83 | |
United
| Professional | $159.93 | $190.24 | $202.02 |