| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $154.83 | $154.83 | $154.83 | |
Aetna
| Professional | $154.83 | $154.83 | $154.83 | |
Cigna
| Professional | $158.56 | $158.56 | $158.56 | |
Regence BlueShield
| Facility | $238.78 | $330.37 | $474.30 | |
United
| Professional | $155.44 | $155.44 | $155.44 |