| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $7.94 | $7.94 | $7.94 | |
Cigna
| Professional | $8.91 | $8.91 | $8.91 | |
Kaiser Permanente
| Professional | $169.82 | $169.82 | $177.83 | |
Moda Health
| Facility | $7.94 | $7.94 | $14.13 | |
Moda Health
| Professional | $7.94 | $7.94 | $7.94 | |
Providence
| Facility | $7.94 | $7.94 | $14.13 | |
Providence
| Professional | $54.95 | $54.95 | $79.43 |