| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $279.00 | $279.00 | $281.30 | |
Aetna
| Professional | $80.94 | $104.34 | $230.02 | |
Cigna
| Professional | $230.50 | $263.14 | $360.54 | |
Moda Health
| Facility | $102.69 | $228.14 | $349.05 | |
Moda Health
| Professional | $255.53 | $306.63 | $472.75 | |
Premera BCBS
| Professional | $145.33 | $395.00 | $522.42 | |
Providence
| Facility | $97.26 | $228.14 | $349.05 | |
Providence
| Professional | $137.75 | $264.16 | $514.50 | |
United
| Professional | $257.75 | $288.44 | $622.70 |