| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $124.65 | $124.65 | $124.65 | |
Aetna
| Professional | $124.65 | $124.65 | $124.65 | |
Cigna
| Professional | $63.43 | $63.43 | $63.43 | |
Regence BlueShield
| Facility | $78.59 | $87.12 | $111.62 | |
United
| Professional | $125.15 | $125.15 | $125.15 |