| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $87.65 | $87.65 | $87.65 | |
Aetna
| Professional | $87.65 | $700.00 | $700.00 | |
Moda Health
| Facility | $700.00 | $721.00 | $896.00 | |
Molina
| Professional | $30.00 | $55.00 | $3,900.00 | |
Regence BlueShield
| Facility | $62.09 | $103.01 | $206.91 |