| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $17.92 | $17.92 | $17.92 | |
Aetna
| Professional | $17.92 | $17.92 | $17.92 | |
Cigna
| Professional | $18.79 | $19.00 | $21.04 | |
Regence BlueShield
| Facility | $18.60 | $21.89 | $26.68 | |
United
| Professional | $13.32 | $17.98 | $21.83 |