| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $95.05 | $95.05 | $95.05 | |
Aetna
| Professional | $87.02 | $95.05 | $130.82 | |
Cigna
| Professional | $92.85 | $92.85 | $92.85 | |
Moda Health
| Facility | $92.70 | $106.23 | $166.34 | |
Moda Health
| Professional | $166.52 | $176.61 | $201.84 | |
Molina
| Professional | $30.00 | $55.00 | $185.35 | |
Regence BlueShield
| Professional | $132.36 | $155.72 | $162.25 | |
United
| Professional | $109.96 | $148.96 | $194.56 |