| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $71.70 | $71.70 | $71.70 | |
Aetna
| Professional | $71.70 | $71.70 | $71.70 | |
Cigna
| Facility | $65.06 | $73.45 | $84.48 | |
Cigna
| Professional | $73.42 | $73.42 | $73.42 | |
Regence BlueShield
| Facility | $90.82 | $115.38 | $165.65 | |
United
| Professional | $71.98 | $71.98 | $71.98 |