| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $107.33 | $107.33 | $107.33 | |
Aetna
| Professional | $107.33 | $107.33 | $277.63 | |
Regence BlueShield
| Facility | $364.66 | $473.16 | $487.72 | |
United
| Professional | $195.26 | $320.24 | $409.65 |