| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $41.38 | $41.38 | $41.38 | |
Aetna
| Professional | $41.38 | $41.38 | $41.38 | |
Regence BlueShield
| Facility | $1,207.49 | $1,338.54 | $1,715.24 | |
United
| Professional | $42.28 | $42.28 | $42.28 |