| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $9,772.37 | $12,022.64 | $16,595.87 | |
Aetna
| Professional | $151.36 | $158.49 | $204.17 | |
Moda Health
| Facility | $102.33 | $204.17 | $295.12 | |
Moda Health
| Professional | $83.18 | $190.55 | $251.19 | |
Premera BCBS
| Professional | $660.69 | $660.69 | $870.96 | |
Providence
| Facility | $107.15 | $204.17 | $295.12 | |
United
| Professional | $218.78 | $389.05 | $707.95 |