| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $347.19 | $347.19 | $347.19 | |
Aetna
| Professional | $163.77 | $175.28 | $347.19 | |
Moda Health
| Facility | $175.28 | $184.04 | $347.19 | |
Molina
| Professional | $30.00 | $55.00 | $3,500.00 | |
Regence BlueShield
| Facility | $260.11 | $308.88 | $436.52 |