| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $126.75 | $126.75 | $158.44 | |
Moda Health
| Professional | $131.59 | $131.59 | $143.04 | |
Pacific Source
| Facility | $244.88 | $244.88 | $244.88 | |
Providence
| Professional | $87.49 | $102.92 | $126.94 |