| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $70.79 | $70.79 | $70.79 | |
Kaiser Permanente
| Professional | $151.36 | $173.78 | $208.93 | |
Moda Health
| Facility | $48.98 | $48.98 | $48.98 | |
Providence
| Facility | $48.98 | $48.98 | $2,570,395.78 | |
Providence
| Professional | $70.79 | $70.79 | $79.43 |