| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $181.97 | $302.00 | $398.11 | |
Kaiser Permanente
| Professional | $229.09 | $302.00 | $371.54 | |
Moda Health
| Facility | $154.88 | $245.47 | $407.38 | |
Pacific Source
| Facility | $251.19 | $309.03 | $323.59 | |
Providence
| Facility | $141.25 | $239.88 | $371.54 |