| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $17.87 | $17.87 | $17.87 | |
Aetna
| Professional | $17.87 | $28.79 | $146.19 | |
Cigna
| Professional | $28.69 | $28.69 | $28.69 | |
Molina
| Professional | $24.41 | $34.88 | $60.00 | |
Regence BlueShield
| Professional | $33.45 | $33.45 | $34.31 | |
United
| Professional | $18.55 | $25.28 | $41.71 |