| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $113.40 | $113.40 | $113.40 | |
Aetna
| Professional | $67.81 | $113.40 | $175.00 | |
Cigna
| Professional | $68.73 | $68.73 | $68.73 | |
Molina
| Professional | $30.00 | $45.00 | $60.00 | |
Regence BlueShield
| Professional | $86.18 | $105.75 | $124.38 | |
United
| Professional | $80.25 | $96.37 | $157.16 |