| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $354.81 | $478.63 | $691.83 | |
Aetna
| Professional | $151.36 | $218.78 | $562.34 | |
Aetna
| Professional | 25 | $63.10 | $63.10 | $288.40 |
Cigna
| Professional | $204.17 | $380.19 | $660.69 | |
Kaiser Permanente
| Professional | $309.03 | $457.09 | $691.83 | |
Moda Health
| Facility | $169.82 | $275.42 | $478.63 | |
Moda Health
| Professional | $245.47 | $426.58 | $660.69 | |
Moda Health
| Professional | 25 | $63.10 | $63.10 | $288.40 |
Pacific Source
| Facility | $346.74 | $537.03 | $549.54 | |
Providence
| Facility | $165.96 | $275.42 | $501.19 | |
Providence
| Professional | $245.47 | $478.63 | $691.83 | |
Regence BlueShield
| Facility | $223.87 | $309.03 | $323.59 | |
Regence BlueShield
| Professional | $316.23 | $457.09 | $660.69 | |
United
| Facility | $380.19 | $380.19 | $380.19 | |
United
| Professional | $223.87 | $380.19 | $602.56 |