| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $65.81 | $130.43 | $130.43 | |
Aetna
| Professional | $60.39 | $130.75 | $166.51 | |
Cigna
| Professional | $128.26 | $128.26 | $128.26 | |
Moda Health
| Facility | $67.81 | $130.75 | $169.56 | |
Moda Health
| Professional | $112.61 | $230.03 | $278.82 | |
Molina
| Professional | $30.00 | $130.43 | $273.24 | |
Regence BlueShield
| Professional | $186.07 | $218.90 | $218.90 | |
United
| Professional | $145.08 | $201.50 | $267.24 |