| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $25.57 | $25.57 | $25.57 | |
Aetna
| Professional | $25.57 | $39.90 | $250.22 | |
Cigna
| Facility | $56.02 | $56.02 | $56.02 | |
Cigna
| Professional | $40.89 | $40.89 | $103.13 | |
Molina
| Professional | $35.00 | $60.00 | $79.87 | |
Regence BlueShield
| Facility | $78.68 | $87.75 | $87.75 | |
Regence BlueShield
| Professional | $49.97 | $62.90 | $94.35 | |
United
| Professional | $35.76 | $39.60 | $39.60 |