| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $149.83 | $149.83 | $224.74 | |
Cigna
| Professional | $164.66 | $164.66 | $164.66 | |
Moda Health
| Facility | $321.38 | $321.38 | $321.38 | |
Moda Health
| Professional | $55.53 | $147.02 | $147.02 | |
Premera BCBS
| Facility | $232.88 | $232.88 | $365.95 | |
Providence
| Facility | $232.88 | $321.38 | $548.91 | |
Providence
| Professional | $55.53 | $79.33 | $164.66 | |
United
| Professional | $147.02 | $147.02 | $176.27 |