| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $464.14 | $464.14 | $464.14 | |
Aetna
| Professional | $464.14 | $464.14 | $464.14 | |
Cigna
| Professional | $475.33 | $475.33 | $475.33 | |
Regence BlueShield
| Facility | $10.09 | $13.39 | $690.46 | |
United
| Professional | $466.01 | $466.01 | $466.01 |