| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $16.64 | $16.64 | $16.64 | |
Aetna
| Professional | $13.31 | $14.14 | $16.64 | |
Moda Health
| Facility | $14.14 | $15.17 | $20.46 | |
Molina
| Professional | $78.00 | $78.00 | $78.00 | |
Regence BlueShield
| Facility | $107.77 | $107.77 | $132.26 |