| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $204.17 | $363.08 | $575.44 | |
Aetna
| Professional | $38.02 | $43.65 | $158.49 | |
Cigna
| Facility | $128.82 | $128.82 | $128.82 | |
Moda Health
| Facility | $46.77 | $46.77 | $223.87 | |
Moda Health
| Professional | $46.77 | $46.77 | $151.36 | |
Premera BCBS
| Facility | $46.77 | $173.78 | $186.21 | |
Premera BCBS
| Professional | $104.71 | $104.71 | $104.71 | |
Providence
| Facility | $38.02 | $128.82 | $223.87 | |
United
| Professional | $28.18 | $93.33 | $141.25 |