| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $134.90 | $134.90 | $134.90 | |
Aetna
| Professional | $134.90 | $171.96 | $332.76 | |
Molina
| Professional | $30.00 | $45.00 | $60.00 | |
Regence BlueShield
| Facility | $348.64 | $462.70 | $624.11 | |
United
| Professional | $699.93 | $699.93 | $699.93 |