| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $42.13 | $52.39 | $114.71 | |
Cigna
| Professional | $49.10 | $49.10 | $49.10 | |
Moda Health
| Facility | $55.31 | $114.71 | $160.59 | |
Moda Health
| Professional | $133.43 | $162.65 | $264.77 | |
Premera BCBS
| Facility | $221.40 | $221.40 | $3,495.87 | |
Premera BCBS
| Professional | $104.65 | $200.00 | $290.44 | |
Providence
| Facility | $49.17 | $114.71 | $160.59 | |
Providence
| Professional | $49.10 | $93.19 | $145.56 | |
United
| Professional | $140.91 | $167.66 | $211.01 |