| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $190.92 | $190.92 | $195.03 | |
Aetna
| Professional | $190.92 | $190.92 | $190.92 | |
Cigna
| Facility | $194.06 | $233.09 | $251.97 | |
Cigna
| Professional | $164.59 | $164.59 | $164.59 | |
Regence BlueShield
| Facility | $164.59 | $164.59 | $461.51 | |
United
| Professional | $164.59 | $164.59 | $164.59 |