| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $149.31 | $149.31 | $149.31 | |
Aetna
| Professional | $149.31 | $149.31 | $386.24 | |
Regence BlueShield
| Facility | $507.41 | $658.33 | $678.24 | |
United
| Professional | $271.64 | $384.51 | $569.89 |