| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $272.89 | $272.89 | $272.89 | |
Aetna
| Professional | $272.89 | $272.89 | $272.89 | |
Regence BlueShield
| Facility | $289.83 | $331.30 | $367.06 | |
United
| Professional | $198.17 | $266.17 | $303.50 |