| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $167.71 | $167.71 | $167.71 | |
Aetna
| Professional | $167.71 | $194.28 | $1,641.41 | |
Cigna
| Facility | $325.37 | $325.37 | $325.37 | |
Cigna
| Professional | $237.52 | $325.37 | $479.81 | |
Molina
| Professional | $266.72 | $430.20 | $559.26 | |
Regence BlueShield
| Facility | $516.01 | $575.48 | $575.48 | |
Regence BlueShield
| Professional | $327.71 | $412.50 | $618.75 | |
United
| Professional | $199.58 | $259.77 | $320.24 |