| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $79.56 | $79.56 | $79.56 | |
Aetna
| Professional | $29.39 | $64.67 | $195.50 | |
Cigna
| Professional | $42.36 | $86.27 | $125.89 | |
Molina
| Professional | $24.93 | $32.34 | $43.66 | |
Regence BlueShield
| Professional | $58.43 | $111.53 | $173.38 | |
United
| Professional | $32.70 | $55.59 | $94.51 |