| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.36 | $0.36 | $0.36 | |
Aetna
| Professional | $0.36 | $0.36 | $0.36 | |
BCBS
| Facility | $39.63 | $104.85 | $178.35 | |
Lucent Health
| Facility | $100.00 | $100.00 | $100.00 | |
Moda Health
| Facility | $0.36 | $0.47 | $1.02 | |
Providence
| Facility | $0.36 | $0.47 | $1.02 |