| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $15.68 | $15.68 | $15.68 | |
Aetna
| Professional | $15.68 | $17.53 | $156.01 | |
Cigna
| Facility | $36.21 | $36.21 | $36.21 | |
Cigna
| Professional | $26.43 | $36.21 | $62.63 | |
Molina
| Professional | $35.00 | $48.09 | $60.00 | |
Regence BlueShield
| Facility | $47.35 | $52.81 | $52.81 | |
Regence BlueShield
| Professional | $30.07 | $37.86 | $56.78 | |
United
| Professional | $19.01 | $24.28 | $34.84 |