| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $37.35 | $37.35 | $37.35 | |
Aetna
| Professional | $37.35 | $37.35 | $37.35 | |
Cigna
| Professional | $38.25 | $38.25 | $38.25 | |
Molina
| Professional | $37.47 | $40.97 | $60.00 | |
Regence BlueShield
| Professional | $42.75 | $52.68 | $55.45 | |
United
| Professional | $37.50 | $37.50 | $37.50 |