| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $450.00 | $450.00 | $450.00 | |
Aetna
| Professional | $450.00 | $450.00 | $450.00 | |
Regence BlueShield
| Facility | $729.72 | $910.01 | $1,306.45 | |
United
| Professional | $441.93 | $589.50 | $657.38 |