| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $77.81 | $77.81 | $77.81 | |
Aetna
| Professional | $77.81 | $77.81 | $77.81 | |
Cigna
| Professional | $79.50 | $79.50 | $79.50 | |
Regence BlueShield
| Facility | $94.47 | $104.72 | $134.19 | |
United
| Professional | $86.16 | $90.69 | $90.69 |