| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $14.26 | $14.26 | $14.26 | |
Aetna
| Professional | $14.26 | $23.39 | $104.17 | |
Cigna
| Professional | $14.73 | $14.73 | $14.73 | |
Molina
| Professional | $29.37 | $32.10 | $60.00 | |
Regence BlueShield
| Professional | $20.07 | $25.27 | $25.27 | |
United
| Professional | $11.98 | $15.31 | $25.52 |