| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $631.16 | $631.16 | $631.16 | |
Aetna
| Professional | $5.81 | $5.81 | $390.25 | |
Moda Health
| Facility | $5.81 | $5.98 | $12.49 | |
Molina
| Professional | $30.00 | $30.00 | $3,500.00 | |
Regence BlueShield
| Facility | $1,416.84 | $1,416.84 | $1,416.84 |