| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $441.26 | $441.26 | $441.26 | |
Aetna
| Professional | $171.15 | $242.05 | $441.26 | |
Molina
| Professional | $30.00 | $45.00 | $60.00 | |
Regence BlueShield
| Facility | $628.24 | $793.54 | $1,151.65 | |
United
| Professional | $699.93 | $699.93 | $699.93 |