| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $77.30 | $77.30 | $174.43 | |
Aetna
| Professional | $58.13 | $130.75 | $174.43 | |
Cigna
| Professional | $128.26 | $128.26 | $128.26 | |
Molina
| Professional | $30.00 | $45.00 | $60.00 | |
Regence BlueShield
| Professional | $87.30 | $168.52 | $211.21 | |
United
| Professional | $117.90 | $153.13 | $215.69 |