| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $400.00 | $400.00 | $400.00 | |
Aetna
| Professional | $87.57 | $125.82 | $755.47 | |
Cigna
| Professional | $486.00 | $486.00 | $486.00 | |
Molina
| Professional | $30.00 | $45.00 | $60.00 | |
Regence BlueShield
| Professional | $39.72 | $44.13 | $57.51 |