| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $26.89 | $26.89 | $26.89 | |
Aetna
| Professional | $26.89 | $26.89 | $69.55 | |
Regence BlueShield
| Facility | $91.28 | $118.53 | $121.92 | |
United
| Professional | $41.65 | $71.34 | $102.62 |