| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $101.65 | $101.65 | $117.93 | |
Aetna
| Professional | $69.65 | $91.22 | $112.05 | |
Cigna
| Professional | $40.00 | $110.01 | $150.55 | |
Moda Health
| Facility | $71.34 | $101.65 | $130.77 | |
Moda Health
| Professional | $114.21 | $137.16 | $166.26 | |
Molina
| Professional | $30.00 | $55.00 | $55.00 | |
Regence BlueShield
| Professional | $98.05 | $116.89 | $141.03 | |
United
| Professional | $86.70 | $117.03 | $169.99 |