| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $90.65 | $90.65 | $90.65 | |
Aetna
| Professional | $80.06 | $90.65 | $126.61 | |
Molina
| Professional | $30.00 | $45.00 | $60.00 | |
Regence BlueShield
| Facility | $108.66 | $137.61 | $200.54 | |
United
| Professional | $79.29 | $79.29 | $79.29 |