| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $27.05 | $27.05 | $27.05 | |
Aetna
| Professional | $27.05 | $27.05 | $27.05 | |
Cigna
| Professional | $14.22 | $14.22 | $14.22 | |
Moda Health
| Facility | $31.14 | $41.41 | $55.39 | |
Moda Health
| Professional | $27.05 | $32.46 | $35.50 | |
Molina
| Professional | $52.75 | $52.75 | $52.75 | |
Regence BlueShield
| Professional | $39.00 | $40.29 | $41.87 | |
United
| Professional | $11.36 | $12.05 | $25.70 |