| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $111.95 | $118.53 | $158.03 | |
Aetna
| Professional | $75.29 | $95.68 | $131.69 | |
Aetna
| Professional | 25 | $91.02 | $91.02 | $91.02 |
Cigna
| Professional | $97.69 | $210.63 | $228.22 | |
Moda Health
| Facility | $122.20 | $131.69 | $188.33 | |
Moda Health
| Professional | $126.60 | $182.28 | $208.32 | |
Regence BlueShield
| Professional | $102.00 | $159.69 | $185.33 | |
United
| Professional | $80.78 | $104.99 | $159.71 |