| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $221.34 | $221.34 | $221.34 | |
Aetna
| Professional | $184.38 | $184.38 | $221.34 | |
Moda Health
| Facility | $184.38 | $184.38 | $236.01 | |
Regence BlueShield
| Facility | $323.47 | $629.95 | $895.63 |