| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $71.68 | $71.68 | $72.09 | |
Aetna
| Professional | $71.68 | $71.68 | $235.95 | |
Cigna
| Facility | $119.15 | $223.47 | $256.99 | |
Cigna
| Professional | $61.80 | $61.80 | $61.80 | |
Regence BlueShield
| Facility | $266.52 | $369.04 | $457.36 | |
United
| Professional | $58.71 | $61.80 | $61.80 |