| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $407.38 | $741.31 | $794.33 | |
Aetna
| Professional | $288.40 | $338.84 | $457.09 | |
Cigna
| Professional | $338.84 | $575.44 | $891.25 | |
Kaiser Permanente
| Professional | $512.86 | $660.69 | $831.76 | |
Moda Health
| Facility | $295.12 | $407.38 | $758.58 | |
Moda Health
| Professional | $323.59 | $630.96 | $891.25 | |
Pacific Source
| Facility | $436.52 | $630.96 | $630.96 | |
Providence
| Facility | $295.12 | $398.11 | $660.69 | |
Providence
| Professional | $380.19 | $645.65 | $851.14 | |
Regence BlueShield
| Professional | $501.19 | $630.96 | $851.14 | |
United
| Professional | $398.11 | $630.96 | $912.01 |