| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $125.20 | $125.20 | $125.20 | |
Aetna
| Professional | $84.19 | $84.95 | $125.20 | |
Cigna
| Professional | $40.50 | $40.50 | $40.50 | |
Molina
| Professional | $30.00 | $45.00 | $60.00 | |
Regence BlueShield
| Professional | $49.64 | $55.16 | $71.89 | |
United
| Facility | $233.00 | $233.00 | $233.00 |