| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $16.14 | $16.14 | $16.14 | |
Aetna
| Professional | $16.14 | $19.57 | $28.18 | |
Cigna
| Professional | $20.00 | $23.00 | $25.90 | |
Molina
| Professional | $30.00 | $45.00 | $47.89 | |
Regence BlueShield
| Professional | $28.50 | $28.50 | $28.50 | |
United
| Professional | $20.85 | $37.44 | $55.49 |