| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $758.56 | $758.56 | $758.56 | |
Aetna
| Professional | $758.56 | $758.56 | $758.56 | |
Cigna
| Professional | $776.84 | $776.84 | $776.84 | |
Regence BlueShield
| Facility | $1,162.29 | $1,468.11 | $2,959.88 | |
United
| Professional | $761.61 | $761.61 | $761.61 |