| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $34.67 | $34.67 | $34.67 | |
Cigna
| Professional | $8.71 | $8.71 | $8.71 | |
Kaiser Permanente
| Professional | $169.82 | $169.82 | $177.83 | |
Moda Health
| Facility | $34.67 | $34.67 | $63.10 | |
Moda Health
| Professional | $34.67 | $34.67 | $34.67 | |
Providence
| Facility | $34.67 | $34.67 | $61.66 | |
Providence
| Professional | $70.79 | $79.43 | $79.43 |