| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,159.84 | $2,159.84 | $2,159.84 | |
Aetna
| Professional | $687.10 | $1,052.08 | $2,159.84 | |
Moda Health
| Facility | $1,052.08 | $1,104.68 | $2,159.84 | |
Molina
| Professional | $30.00 | $55.00 | $3,900.00 | |
Regence BlueShield
| Facility | $980.42 | $1,449.33 | $1,775.72 |