| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $112.83 | $112.83 | $161.36 | |
Aetna
| Professional | $79.90 | $127.51 | $231.20 | |
Aetna
| Professional | 25 | $18.02 | $91.40 | $295.58 |
Cigna
| Professional | $56.50 | $131.09 | $243.93 | |
Molina
| Professional | $115.98 | $143.16 | $183.27 | |
Regence BlueShield
| Professional | $106.09 | $153.74 | $213.84 | |
United
| Professional | $115.70 | $137.38 | $215.73 |