| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $278.77 | $278.77 | $278.77 | |
Aetna
| Professional | $85.03 | $85.03 | $278.77 | |
Molina
| Professional | $30.00 | $45.00 | $60.00 | |
Regence BlueShield
| Facility | $105.36 | $131.38 | $188.62 | |
United
| Professional | $89.89 | $89.89 | $89.89 |