| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.03 | $0.03 | $0.03 | |
Aetna
| Professional | $0.03 | $0.03 | $0.03 | |
Cigna
| Professional | $20.03 | $20.03 | $20.03 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 | |
Regence BlueShield
| Professional | $11.10 | $11.10 | $11.10 |