| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $74.20 | $74.20 | $74.20 | |
Aetna
| Professional | $74.20 | $74.20 | $74.20 | |
Cigna
| Professional | $75.98 | $75.98 | $75.98 | |
Regence BlueShield
| Facility | $114.83 | $143.56 | $206.10 | |
United
| Professional | $74.50 | $74.50 | $74.50 |