| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.89 | $30.89 | $30.89 | |
Aetna
| Professional | $30.89 | $59.92 | $276.66 | |
Cigna
| Facility | $59.92 | $59.92 | $59.92 | |
Cigna
| Professional | $43.74 | $66.48 | $79.80 | |
Molina
| Professional | $43.56 | $70.01 | $91.01 | |
Regence BlueShield
| Facility | $83.97 | $93.65 | $93.65 | |
Regence BlueShield
| Professional | $53.33 | $67.13 | $100.70 | |
United
| Professional | $17.26 | $47.41 | $57.54 |