| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $85.11 | $192.66 | $192.66 | |
Cigna
| Professional | $52.45 | $52.45 | $52.45 | |
Moda Health
| Professional | $116.68 | $116.68 | $220.50 | |
Premera BCBS
| Professional | $58.94 | $157.50 | $230.58 | |
Providence
| Professional | $52.45 | $157.50 | $231.25 | |
United
| Professional | $182.40 | $182.40 | $182.40 |