| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $335.01 | $335.01 | $335.01 | |
Cigna
| Facility | $278.10 | $278.10 | $278.10 | |
Cigna
| Professional | $203.01 | $278.10 | $286.44 | |
Moda Health
| Facility | $84.12 | $84.12 | $84.12 | |
Moda Health
| Professional | $109.75 | $368.03 | $581.10 | |
Premera BCBS
| Facility | $173.40 | $173.40 | $377.27 | |
Premera BCBS
| Professional | $271.83 | $377.27 | $821.35 | |
Providence
| Facility | $84.12 | $84.12 | $278.10 | |
Providence
| Professional | $203.01 | $290.44 | $452.72 | |
United
| Professional | $197.12 | $305.20 | $508.68 |