| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $446.68 | $1,288.25 | $3,467.37 | |
Aetna
| Professional | $316.23 | $316.23 | $446.68 | |
Cigna
| Professional | $52.48 | $52.48 | $52.48 | |
Molina
| Professional | $30.20 | $30.20 | $30.20 | |
Regence BlueShield
| Facility | $602.56 | $724.44 | $1,548.82 |