| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $10.00 | $10.00 | $10.00 | |
Moda Health
| Facility | $10.00 | $10.00 | $13.70 | |
Moda Health
| Professional | $17,728.12 | $17,728.12 | $17,728.12 | |
Providence
| Facility | $10.00 | $10.00 | $13.70 | |
Regence BlueShield
| Professional | $67.28 | $70.81 | $70.81 |