| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $94.67 | $94.67 | $94.67 | |
Aetna
| Professional | $82.17 | $97.58 | $132.75 | |
Cigna
| Professional | $92.55 | $92.55 | $92.55 | |
Moda Health
| Facility | $85.20 | $129.38 | $159.30 | |
Moda Health
| Professional | $165.99 | $176.05 | $201.20 | |
Molina
| Professional | $30.00 | $55.00 | $184.61 | |
Regence BlueShield
| Professional | $131.51 | $154.72 | $162.25 | |
United
| Professional | $112.84 | $137.24 | $191.03 |