| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $82.18 | $82.18 | $82.18 | |
Aetna
| Professional | $75.41 | $91.55 | $116.44 | |
Cigna
| Professional | $79.45 | $79.45 | $79.45 | |
Moda Health
| Facility | $82.18 | $116.44 | $149.04 | |
Moda Health
| Professional | $142.51 | $151.15 | $172.74 | |
Molina
| Professional | $30.00 | $55.00 | $160.25 | |
Regence BlueShield
| Professional | $112.91 | $132.83 | $139.22 | |
United
| Professional | $95.40 | $132.50 | $169.28 |