| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $70.28 | $70.28 | $70.28 | |
Aetna
| Professional | $70.28 | $70.28 | $70.28 | |
Cigna
| Professional | $60.25 | $60.25 | $60.25 | |
Regence BlueShield
| Facility | $38.65 | $42.84 | $54.90 | |
United
| Professional | $67.04 | $70.56 | $70.56 |