| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $25.00 | $25.00 | $25.00 | |
BCBS
| Facility | $79.92 | $90.72 | $108.00 | |
Moda Health
| Facility | $21.25 | $25.00 | $25.00 | |
Moda Health
| Professional | $25.00 | $25.00 | $25.00 | |
Providence
| Facility | $25.00 | $25.00 | $25.00 | |
Providence
| Professional | $25.00 | $25.00 | $25.00 | |
Wellpoint
| Professional | $45.00 | $45.00 | $45.00 |