| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $126.61 | $126.61 | $126.61 | |
Aetna
| Professional | $80.06 | $80.06 | $126.61 | |
Moda Health
| Facility | $80.06 | $84.06 | $126.61 | |
Molina
| Professional | $30.00 | $55.00 | $3,900.00 | |
Regence BlueShield
| Facility | $130.83 | $184.54 | $229.78 |