| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $77.13 | $77.13 | $77.48 | |
Aetna
| Professional | $55.66 | $67.00 | $143.99 | |
Aetna
| Professional | 25 | $209.60 | $209.60 | $245.55 |
Cigna
| Professional | $73.89 | $99.79 | $133.61 | |
Molina
| Professional | $47.35 | $61.16 | $75.49 | |
Regence BlueShield
| Professional | $70.66 | $81.64 | $120.73 | |
United
| Professional | $63.81 | $86.50 | $126.60 |