| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.00 | $30.00 | $30.00 | |
Aetna
| Professional | $30.00 | $30.00 | $30.00 | |
Cigna
| Professional | $14.68 | $14.68 | $14.68 | |
Molina
| Professional | $27.77 | $36.10 | $45.00 | |
Regence BlueShield
| Facility | $36.93 | $36.93 | $36.93 | |
Regence BlueShield
| Professional | $26.63 | $26.63 | $26.63 | |
United
| Professional | $14.77 | $22.16 | $22.82 |