| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $794.33 | $794.33 | $794.33 | |
Aetna
| Professional | $794.33 | $794.33 | $933.25 | |
Cigna
| Professional | $269.15 | $269.15 | $269.15 | |
Molina
| Professional | $30.20 | $30.20 | $30.20 | |
Regence BlueShield
| Facility | $1,174.90 | $1,380.38 | $3,162.28 |