| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $603.50 | $603.50 | $603.50 | |
Aetna
| Professional | $585.04 | $603.50 | $1,771.57 | |
Molina
| Professional | $30.00 | $45.00 | $60.00 | |
Regence BlueShield
| Facility | $907.10 | $1,131.08 | $1,623.83 | |
United
| Professional | $683.77 | $683.77 | $683.77 |