| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $111.82 | $111.82 | $111.82 | |
Aetna
| Professional | $96.70 | $112.87 | $157.49 | |
Cigna
| Professional | $107.43 | $107.43 | $107.43 | |
Moda Health
| Facility | $100.64 | $152.22 | $188.99 | |
Moda Health
| Professional | $192.67 | $204.35 | $233.54 | |
Molina
| Professional | $30.00 | $55.00 | $218.05 | |
Regence BlueShield
| Professional | $152.66 | $179.60 | $188.42 | |
United
| Professional | $132.19 | $168.82 | $231.31 |