| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $132.13 | $305.06 | $305.06 | |
Cigna
| Facility | $192.25 | $192.25 | $192.25 | |
Cigna
| Professional | $140.34 | $192.25 | $198.02 | |
Moda Health
| Facility | $104.04 | $294.64 | $348.39 | |
Moda Health
| Professional | $313.55 | $330.97 | $348.39 | |
Molina
| Professional | $30.00 | $260.27 | $313.55 | |
Regence BlueShield
| Facility | $305.06 | $340.22 | $510.33 | |
Regence BlueShield
| Professional | $243.87 | $243.87 | $365.81 | |
United
| Professional | $141.91 | $153.49 | $261.83 |