| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $122.26 | $122.26 | $122.26 | |
Aetna
| Professional | $98.16 | $122.26 | $402.18 | |
Cigna
| Professional | $123.73 | $161.13 | $277.20 | |
Molina
| Professional | $71.61 | $93.51 | $114.31 | |
Regence BlueShield
| Professional | $171.64 | $242.19 | $369.07 | |
United
| Professional | $100.15 | $131.43 | $194.41 |