| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $83.06 | $83.06 | $83.06 | |
Aetna
| Professional | $83.06 | $83.06 | $214.87 | |
Regence BlueShield
| Facility | $282.48 | $366.05 | $377.23 | |
United
| Professional | $151.12 | $220.40 | $317.04 |