| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $60.00 | $60.00 | $60.00 | |
Cigna
| Facility | $90.00 | $120.00 | $125.00 | |
Cigna
| Professional | $90.00 | $118.65 | $148.31 | |
Molina
| Professional | $45.00 | $45.00 | $60.00 | |
Regence BlueShield
| Professional | $95.00 | $95.00 | $160.00 |