| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $10.42 | $10.42 | $10.42 | |
Aetna
| Professional | $10.42 | $22.84 | $109.86 | |
Cigna
| Professional | $19.44 | $19.44 | $19.44 | |
Molina
| Professional | $25.01 | $30.98 | $44.08 | |
Regence BlueShield
| Professional | $21.18 | $26.65 | $26.65 | |
United
| Professional | $12.64 | $16.14 | $24.32 |