| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $130.93 | $130.93 | $130.93 | |
Aetna
| Professional | $102.41 | $130.93 | $329.57 | |
Cigna
| Professional | $128.76 | $168.00 | $288.56 | |
Molina
| Professional | $95.87 | $125.86 | $152.66 | |
Regence BlueShield
| Professional | $178.60 | $252.99 | $384.22 | |
United
| Professional | $107.55 | $134.80 | $204.17 |