| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $25.62 | $57.99 | $57.99 | |
Cigna
| Professional | $24.15 | $24.15 | $24.15 | |
Moda Health
| Professional | $18.19 | $18.19 | $54.57 | |
Premera BCBS
| Professional | $15.98 | $15.98 | $39.96 | |
Providence
| Professional | $24.15 | $24.15 | $24.15 | |
United
| Professional | $48.00 | $48.00 | $48.00 |