| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,500.00 | $4,500.00 | $5,519.00 | |
Aetna
| Professional | $132.60 | $132.60 | $132.60 | |
Molina
| Professional | $30.00 | $78.00 | $3,900.00 | |
Regence BlueShield
| Facility | $53.06 | $68.47 | $101.76 |