| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $190.55 | $190.55 | $190.55 | |
Aetna
| Professional | $190.55 | $190.55 | $190.55 | |
BCBS
| Facility | $19.95 | $21.88 | $34.67 | |
Moda Health
| Facility | $190.55 | $190.55 | $190.55 | |
Moda Health
| Professional | $190.55 | $190.55 | $190.55 | |
Regence BlueShield
| Facility | $34.67 | $34.67 | $34.67 |