| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $94.67 | $94.67 | $94.67 | |
Aetna
| Professional | $86.61 | $98.16 | $139.25 | |
Cigna
| Professional | $92.55 | $92.55 | $92.55 | |
Moda Health
| Facility | $86.61 | $99.46 | $135.54 | |
Moda Health
| Professional | $165.99 | $176.05 | $201.20 | |
Molina
| Professional | $30.00 | $55.00 | $184.61 | |
Regence BlueShield
| Professional | $131.51 | $154.72 | $162.25 | |
United
| Professional | $112.84 | $140.30 | $192.14 |