| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $69.65 | $69.65 | $69.65 | |
Aetna
| Professional | $69.65 | $69.65 | $69.65 | |
Cigna
| Facility | $146.00 | $178.87 | $298.14 | |
Cigna
| Professional | $47.60 | $47.60 | $47.60 | |
Regence BlueShield
| Facility | $251.26 | $333.47 | $449.79 | |
United
| Professional | $46.67 | $46.67 | $46.67 |