| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $591.08 | $591.08 | $591.08 | |
Aetna
| Professional | $591.08 | $591.08 | $795.51 | |
Regence BlueShield
| Facility | $936.97 | $1,038.65 | $1,369.80 | |
United
| Professional | $428.66 | $1,078.58 | $1,568.48 |