| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $16.14 | $16.14 | $16.14 | |
Aetna
| Professional | $16.14 | $19.47 | $26.58 | |
Cigna
| Professional | $19.34 | $24.00 | $30.09 | |
Molina
| Professional | $30.00 | $45.00 | $60.00 | |
Regence BlueShield
| Professional | $28.50 | $28.50 | $28.50 | |
United
| Professional | $23.01 | $36.00 | $53.36 |