| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $59.63 | $91.54 | $91.54 | |
Aetna
| Professional | $91.54 | $91.54 | $91.54 | |
Cigna
| Facility | $65.40 | $74.76 | $87.45 | |
Cigna
| Professional | $78.92 | $78.92 | $78.92 | |
Regence BlueShield
| Facility | $81.23 | $112.39 | $161.36 | |
United
| Professional | $78.92 | $78.92 | $87.85 |