| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $62.25 | $62.25 | $62.25 | |
Aetna
| Professional | $62.25 | $62.25 | $62.25 | |
Cigna
| Professional | $63.75 | $63.75 | $63.75 | |
Regence BlueShield
| Facility | $243.92 | $337.48 | $484.50 | |
United
| Professional | $59.38 | $62.50 | $62.50 |