| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $280.86 | $280.86 | $280.86 | |
Aetna
| Professional | $280.86 | $412.43 | $429.48 | |
Moda Health
| Facility | $412.43 | $424.80 | $527.91 | |
Molina
| Professional | $30.00 | $55.00 | $3,900.00 | |
Regence BlueShield
| Facility | $413.59 | $570.53 | $894.98 |