| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $53.27 | $53.27 | $53.27 | |
Aetna
| Professional | $53.27 | $53.27 | $53.27 | |
Cigna
| Professional | $54.55 | $54.55 | $54.55 | |
Regence BlueShield
| Facility | $87.32 | $120.82 | $173.45 | |
United
| Professional | $53.60 | $56.42 | $56.42 |