| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.38 | $86.97 | $173.73 | |
Aetna
| Professional | $55.29 | $81.18 | $289.00 | |
Aetna
| Professional | CQ | $85.28 | $85.28 | $85.28 |
Cigna
| Facility | $72.00 | $72.00 | $75.00 | |
Cigna
| Professional | $61.60 | $84.73 | $118.47 | |
Molina
| Professional | $72.17 | $90.79 | $106.03 | |
Regence BlueShield
| Facility | $128.04 | $143.29 | $182.99 | |
Regence BlueShield
| Professional | $97.68 | $114.26 | $118.81 | |
United
| Professional | $75.15 | $86.64 | $98.01 |