| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $107.42 | $107.42 | $107.42 | |
Aetna
| Professional | $107.42 | $107.42 | $107.42 | |
Regence BlueShield
| Facility | $130.54 | $144.69 | $185.44 | |
United
| Professional | $129.41 | $129.41 | $129.41 |