| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $42.00 | $42.00 | $42.00 | |
Aetna
| Professional | $42.00 | $42.00 | $83.20 | |
Cigna
| Professional | $39.75 | $39.75 | $39.75 | |
Molina
| Professional | $38.90 | $50.58 | $60.00 | |
Regence BlueShield
| Facility | $51.86 | $51.86 | $51.86 | |
Regence BlueShield
| Professional | $37.39 | $37.39 | $37.39 | |
United
| Professional | $20.74 | $31.12 | $51.86 |