| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $112.95 | $112.95 | $112.95 | |
Aetna
| Professional | $79.19 | $93.08 | $119.38 | |
Cigna
| Professional | $92.55 | $92.55 | $92.55 | |
Molina
| Professional | $71.61 | $86.03 | $101.21 | |
Regence BlueShield
| Professional | $107.20 | $124.40 | $159.51 | |
United
| Professional | $88.45 | $118.95 | $176.11 |