| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $49.81 | $49.81 | $49.81 | |
Aetna
| Professional | $49.81 | $51.12 | $51.12 | |
Moda Health
| Facility | $51.12 | $51.12 | $65.43 | |
Regence BlueShield
| Facility | $70.59 | $137.90 | $188.03 |