| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $82.27 | $82.27 | $82.27 | |
Aetna
| Professional | $61.56 | $82.27 | $120.97 | |
Aetna
| Professional | 25 | $145.34 | $145.34 | $145.34 |
Cigna
| Professional | $67.86 | $107.18 | $184.10 | |
Molina
| Professional | $95.82 | $114.21 | $134.36 | |
Regence BlueShield
| Facility | $221.79 | $306.86 | $440.54 | |
Regence BlueShield
| Professional | $81.69 | $122.74 | $154.47 | |
United
| Professional | $76.80 | $114.03 | $151.83 |