| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $63.00 | $63.00 | $63.00 | |
Aetna
| Professional | $37.70 | $63.00 | $105.00 | |
Cigna
| Professional | $38.22 | $38.22 | $38.22 | |
Molina
| Professional | $30.00 | $45.00 | $60.00 | |
Regence BlueShield
| Professional | $47.92 | $58.80 | $69.15 | |
United
| Professional | $44.36 | $62.38 | $86.94 |