| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $170.67 | $170.67 | $170.67 | |
Aetna
| Professional | $88.52 | $129.60 | $263.00 | |
Cigna
| Professional | $115.76 | $115.76 | $115.76 | |
Molina
| Professional | $95.70 | $117.53 | $140.57 | |
Regence BlueShield
| Professional | $134.09 | $181.42 | $212.47 | |
United
| Professional | $116.54 | $145.54 | $233.64 |