| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $22.43 | $22.43 | $22.43 | |
Aetna
| Professional | $22.43 | $22.43 | $22.43 | |
Cigna
| Professional | $22.97 | $22.97 | $22.97 | |
Regence BlueShield
| Facility | $12.88 | $16.05 | $23.06 | |
United
| Professional | $22.52 | $22.52 | $22.52 |