| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $33.08 | $33.08 | $33.08 | |
Aetna
| Professional | $28.52 | $28.52 | $33.08 | |
Cigna
| Professional | $28.52 | $28.52 | $28.52 | |
Molina
| Professional | $30.00 | $45.00 | $60.00 | |
Regence BlueShield
| Facility | $54.93 | $70.53 | $98.34 | |
Regence BlueShield
| Professional | $31.37 | $38.65 | $40.69 | |
United
| Professional | $28.52 | $28.52 | $28.52 |