| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $22.15 | $22.15 | $22.15 | |
Aetna
| Professional | $16.42 | $19.60 | $33.00 | |
Cigna
| Professional | $21.02 | $26.97 | $41.32 | |
Molina
| Professional | $32.47 | $36.20 | $131.05 | |
Regence BlueShield
| Professional | $28.67 | $37.47 | $47.93 | |
United
| Professional | $15.88 | $21.21 | $28.00 |