| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $123.21 | $123.21 | $123.21 | |
Aetna
| Professional | $90.50 | $106.38 | $149.63 | |
Cigna
| Professional | $121.48 | $157.34 | $241.41 | |
Molina
| Professional | $71.44 | $93.51 | $113.84 | |
Regence BlueShield
| Professional | $171.64 | $241.34 | $381.86 | |
United
| Professional | $103.36 | $141.96 | $202.22 |