| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $203.59 | $203.59 | $203.59 | |
Aetna
| Professional | $203.59 | $257.82 | $452.65 | |
Cigna
| Professional | $359.63 | $359.63 | $359.63 | |
Molina
| Professional | $30.00 | $45.00 | $1,265.09 | |
Regence BlueShield
| Professional | $476.11 | $476.11 | $476.11 | |
United
| Professional | $177.30 | $283.23 | $478.96 |