| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $60.00 | $60.00 | $60.00 | |
Aetna
| Professional | $20.00 | $60.00 | $128.86 | |
Cigna
| Professional | $33.50 | $41.78 | $41.78 | |
Molina
| Professional | $30.00 | $45.00 | $60.00 | |
Regence BlueShield
| Professional | $24.82 | $27.58 | $35.96 |