| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $88.70 | $88.70 | $88.70 | |
Aetna
| Professional | $57.15 | $88.70 | $120.43 | |
Cigna
| Professional | $47.79 | $47.79 | $47.79 | |
Moda Health
| Facility | $66.01 | $119.03 | $142.96 | |
Moda Health
| Professional | $113.08 | $113.08 | $119.03 | |
Molina
| Professional | $184.50 | $208.30 | $232.11 | |
Regence BlueShield
| Professional | $108.86 | $108.86 | $108.86 | |
United
| Professional | $46.67 | $50.47 | $89.45 |