| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $69.72 | $69.72 | $169.58 | |
Aetna
| Professional | $69.72 | $69.72 | $69.72 | |
Cigna
| Professional | $71.40 | $71.40 | $71.40 | |
Molina
| Professional | $45.00 | $56.14 | $61.36 | |
Regence BlueShield
| Professional | $79.80 | $98.33 | $103.50 | |
United
| Professional | $79.80 | $79.80 | $79.80 |