| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $61.78 | $61.78 | $61.78 | |
Aetna
| Professional | $61.78 | $95.49 | $425.18 | |
Cigna
| Professional | $60.12 | $60.12 | $60.12 | |
Molina
| Professional | $60.00 | $119.85 | $131.00 | |
Regence BlueShield
| Professional | $81.95 | $103.16 | $103.16 | |
United
| Professional | $48.93 | $62.49 | $101.30 |