| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $72.79 | $72.79 | $72.79 | |
Aetna
| Professional | $72.79 | $119.89 | $360.89 | |
Cigna
| Professional | $135.78 | $135.78 | $135.78 | |
Molina
| Professional | $60.00 | $194.83 | $243.53 | |
Regence BlueShield
| Professional | $147.86 | $186.13 | $186.13 | |
United
| Professional | $88.29 | $112.76 | $169.85 |