| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $44.98 | $44.98 | $44.98 | |
Pacific Source
| Facility | $27.99 | $38.40 | $79,999.20 | |
Regence BlueShield
| Professional | $252.36 | $252.36 | $265.74 | |
United
| Professional | $36.32 | $36.32 | $39.61 |