| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $131.99 | $161.40 | $574.00 | |
Aetna
| Professional | 25 | $212.65 | $212.65 | $212.65 |
Cigna
| Professional | $140.77 | $172.31 | $380.90 | |
Molina
| Professional | $60.00 | $155.59 | $189.74 | |
Regence BlueShield
| Professional | $284.94 | $284.94 | $316.60 | |
United
| Professional | $153.00 | $177.10 | $278.29 |