| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $37.10 | $37.10 | $37.10 | |
Aetna
| Professional | $37.10 | $53.96 | $331.52 | |
Cigna
| Facility | $53.85 | $53.85 | $53.85 | |
Cigna
| Professional | $39.31 | $53.85 | $57.40 | |
Molina
| Professional | $44.03 | $62.91 | $81.78 | |
Regence BlueShield
| Facility | $75.45 | $84.16 | $84.16 | |
Regence BlueShield
| Professional | $47.92 | $60.33 | $90.49 | |
United
| Professional | $33.65 | $43.00 | $53.96 |