| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $166.47 | $166.47 | $166.47 | |
Aetna
| Professional | $85.03 | $85.03 | $278.77 | |
Moda Health
| Facility | $157.94 | $165.85 | $209.29 | |
Molina
| Professional | $30.00 | $55.00 | $3,900.00 | |
Regence BlueShield
| Facility | $129.26 | $182.76 | $270.37 |