| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $890.93 | $890.93 | $890.93 | |
Aetna
| Professional | $751.56 | $751.56 | $890.93 | |
Cigna
| Professional | $477.77 | $477.77 | $477.77 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 | |
Regence BlueShield
| Facility | $1,183.54 | $1,518.13 | $2,212.35 |