| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $107.61 | $107.61 | $107.61 | |
Aetna
| Professional | $98.54 | $119.30 | $152.03 | |
Cigna
| Professional | $104.45 | $104.45 | $104.45 | |
Moda Health
| Facility | $107.61 | $152.03 | $194.60 | |
Moda Health
| Professional | $187.34 | $198.70 | $227.08 | |
Molina
| Professional | $30.00 | $30.00 | $166.80 | |
Regence BlueShield
| Professional | $148.01 | $174.13 | $182.14 | |
United
| Professional | $124.56 | $172.50 | $220.76 |