| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $144.46 | $144.46 | $144.46 | |
Aetna
| Professional | $115.60 | $144.46 | $481.00 | |
Cigna
| Professional | $151.88 | $199.28 | $308.02 | |
Molina
| Professional | $95.87 | $125.86 | $152.66 | |
Regence BlueShield
| Professional | $209.45 | $308.92 | $464.07 | |
United
| Professional | $126.13 | $168.17 | $247.80 |