| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $696.50 | $696.50 | $696.50 | |
Moda Health
| Professional | $229.51 | $229.51 | $229.51 | |
Pacific Source
| Facility | $180.66 | $376.00 | $602.00 | |
Providence
| Facility | $696.50 | $696.50 | $1,644,126.80 | |
Regence BlueShield
| Facility | $669.14 | $808.63 | $1,041.28 |