| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $40.28 | $49.88 | $109.70 | |
Cigna
| Professional | $47.02 | $47.02 | $47.02 | |
Moda Health
| Facility | $53.52 | $109.70 | $153.58 | |
Moda Health
| Professional | $127.78 | $154.71 | $251.86 | |
Premera BCBS
| Facility | $213.30 | $213.30 | $3,495.87 | |
Premera BCBS
| Professional | $100.75 | $195.00 | $278.05 | |
Providence
| Facility | $47.87 | $109.70 | $153.58 | |
Providence
| Professional | $47.02 | $88.87 | $142.86 | |
United
| Professional | $136.61 | $159.94 | $201.29 |