| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $206.70 | $206.70 | $206.70 | |
Cigna
| Professional | $206.70 | $206.70 | $206.70 | |
Moda Health
| Professional | $146.28 | $146.28 | $146.28 | |
Molina
| Professional | $78.00 | $78.00 | $78.00 | |
Regence BlueShield
| Facility | $156.30 | $223.29 | $372.15 | |
United
| Professional | $234.00 | $234.00 | $327.60 |