| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $75.00 | $75.00 | $75.00 | |
Aetna
| Professional | $57.15 | $75.00 | $120.43 | |
Cigna
| Professional | $47.79 | $47.79 | $47.79 | |
Molina
| Professional | $60.00 | $87.21 | $109.01 | |
Regence BlueShield
| Professional | $108.86 | $108.86 | $108.86 | |
United
| Professional | $39.52 | $50.47 | $60.71 |