| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $25.91 | $25.91 | $25.91 | |
Aetna
| Professional | $25.91 | $50.23 | $241.55 | |
Cigna
| Professional | $34.15 | $34.15 | $34.15 | |
Molina
| Professional | $60.00 | $68.11 | $95.75 | |
Regence BlueShield
| Professional | $46.56 | $58.60 | $58.60 | |
United
| Professional | $27.80 | $35.50 | $59.17 |